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Contact Information

ILENE BRACKIN, PA-C
310 N 10TH ST
BISMARCK, ND58501-4516
 Phone: 701-530-7500
 Fax: 701-530-7484
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ILENE BRACKIN · (Female)

NPI Number 1457451981
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 09/24/2006
Last updated 12/28/2023 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • ND License # PAC0236
  • ND Other 1457451981 NPI
  • ND Other P00210194 RAILROAD MEDICARE
Hospital affiliation(s)
  • MEDCENTER ONE - (Acute Care)
    300 N 7TH ST
    BISMARCK, ND 58506
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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