Provider Demographics
NPI:1093032716
Name:PAULETTE C BRANCH
Entity Type:Organization
Organization Name:PAULETTE C BRANCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:BRANCH
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:330-760-0605
Mailing Address - Street 1:PO BOX 755
Mailing Address - Street 2:
Mailing Address - City:NEWCOMERSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43832-0755
Mailing Address - Country:US
Mailing Address - Phone:330-760-0606
Mailing Address - Fax:
Practice Address - Street 1:75959 VANDALIA LN # 104
Practice Address - Street 2:
Practice Address - City:KIMBOLTON
Practice Address - State:OH
Practice Address - Zip Code:43749-9785
Practice Address - Country:US
Practice Address - Phone:330-760-0605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN139141251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care