Provider Demographics
NPI:1124367552
Name:BRAYMER, SANDI ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:SANDI
Middle Name:ANN
Last Name:BRAYMER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3739
Mailing Address - Country:US
Mailing Address - Phone:518-793-7419
Mailing Address - Fax:518-792-2557
Practice Address - Street 1:120 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3739
Practice Address - Country:US
Practice Address - Phone:518-793-7419
Practice Address - Fax:518-792-2557
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY615515-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool