Provider Demographics
NPI:1376976472
Name:BRAMMER, AMANDIA (STNA)
Entity Type:Individual
Prefix:
First Name:AMANDIA
Middle Name:
Last Name:BRAMMER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-4101
Mailing Address - Country:US
Mailing Address - Phone:740-244-4612
Mailing Address - Fax:
Practice Address - Street 1:721 SHORE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-4101
Practice Address - Country:US
Practice Address - Phone:740-244-4612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401502570413376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide