Basic Information
Provider Information
NPI: 1750315370
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRANIFF
FirstName: KAREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
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Mailing Information
Address1: 3800 WOODWARD AVE
Address2: SUITE 702
City: DETROIT
State: MI
PostalCode: 482012061
CountryCode: US
TelephoneNumber: 3132621303
FaxNumber: 3132621238
Practice Location
Address1: CHILDREN'S HOSPITAL OF MI
Address2: 3901 BEAUBIEN 2ND FLOOR CARLS'S BUILDING
City: DETROIT
State: MI
PostalCode: 48201
CountryCode: US
TelephoneNumber: 3137455541
FaxNumber: 3139932948
Other Information
ProviderEnumerationDate: 07/10/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X4704115105MIY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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