Brackin, Ilene

Brackin, Ilene is an individual health care provider with primary practice located at 310 N 10Th St , Bismarck ND 58501-4516. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Brackin, Ilene can be contacted via phone (701) 530-7500.

Contact Information

Primary practice address
310 N 10Th St Bismarck ND 58501-4516
Phone: (701) 530-7500
Fax: (701) 530-7484
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PAC0236 North Dakota
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PAC0236 North Dakota
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X

Profile Details

NPI number 1457451981
LBN Legal business name Brackin, Ilene
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 24th, 2006
Last updated Dec 28th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457451981 NPPES
North Dakota Other P00210194 RAILROAD MEDICARE
North Dakota Other 1457451981 RAILROAD MEDICARE

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