Provider Demographics
NPI:1194472126
Name:BRADEN, TERI SHANEE
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:SHANEE
Last Name:BRADEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 BRIGHTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-2302
Mailing Address - Country:US
Mailing Address - Phone:513-882-5299
Mailing Address - Fax:
Practice Address - Street 1:1639 BRIGHTVIEW DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-2302
Practice Address - Country:US
Practice Address - Phone:513-882-5299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide