Provider Demographics
NPI:1285223313
Name:BEARD, BRANDON JAMHAL
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:JAMHAL
Last Name:BEARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3942 ARLINGTON RD UNIT 1103
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-9802
Mailing Address - Country:US
Mailing Address - Phone:234-804-7583
Mailing Address - Fax:
Practice Address - Street 1:3942 ARLINGTON RD UNIT 1103
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-9802
Practice Address - Country:US
Practice Address - Phone:234-804-7583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide