Provider Demographics
NPI:1366038697
Name:LANEY, BRANDON (RN)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:LANEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 KAGEY ST
Mailing Address - Street 2:
Mailing Address - City:MINERAL POINT
Mailing Address - State:PA
Mailing Address - Zip Code:15942-5918
Mailing Address - Country:US
Mailing Address - Phone:724-464-7600
Mailing Address - Fax:
Practice Address - Street 1:168 KAGEY ST
Practice Address - Street 2:
Practice Address - City:MINERAL POINT
Practice Address - State:PA
Practice Address - Zip Code:15942-5918
Practice Address - Country:US
Practice Address - Phone:724-464-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN723435163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse