Provider Demographics
NPI:1366631574
Name:BRANUM, PATRICIA LOUISE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LOUISE
Last Name:BRANUM
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 YORK ROAD, 3RD FLOOR
Mailing Address - Street 2:BALTIMORE COUNTY DEPARTMENT OF HEALTH
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2112
Mailing Address - Country:US
Mailing Address - Phone:410-887-2754
Mailing Address - Fax:
Practice Address - Street 1:6401 YORK ROAD, 3RD FLOOR
Practice Address - Street 2:BALTIMORE COUNTY DEPARTMENT OF HEALTH
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2112
Practice Address - Country:US
Practice Address - Phone:410-887-2754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR148247163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health