Provider Demographics
NPI:1184847493
Name:BRANHAM, ERIKA FAITH (CPHT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:FAITH
Last Name:BRANHAM
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 PADDOCK DR
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1787
Mailing Address - Country:US
Mailing Address - Phone:859-873-2536
Mailing Address - Fax:
Practice Address - Street 1:1230 US HIGHWAY 127 S
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4319
Practice Address - Country:US
Practice Address - Phone:502-875-2550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY170108783477139183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician