Provider Demographics
NPI:1376890988
Name:MCDONALD, BRANDY LYNN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:BRANDY
Middle Name:LYNN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5692 EVANS RD
Mailing Address - Street 2:
Mailing Address - City:CABLE
Mailing Address - State:OH
Mailing Address - Zip Code:43009-9606
Mailing Address - Country:US
Mailing Address - Phone:567-204-5606
Mailing Address - Fax:
Practice Address - Street 1:5692 EVANS RD
Practice Address - Street 2:
Practice Address - City:CABLE
Practice Address - State:OH
Practice Address - Zip Code:43009-9606
Practice Address - Country:US
Practice Address - Phone:567-204-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.130957164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse