Provider Demographics
NPI:1467521138
Name:BRANSFORD, JANICE LENORE (PHD, APRN)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LENORE
Last Name:BRANSFORD
Suffix:
Gender:F
Credentials:PHD, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1357 WOLF RUN RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-4779
Mailing Address - Country:US
Mailing Address - Phone:775-750-7941
Mailing Address - Fax:
Practice Address - Street 1:8600 TECHNOLOGY WAY # 118
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521
Practice Address - Country:US
Practice Address - Phone:775-268-0218
Practice Address - Fax:775-826-0219
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN000653363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002416111Medicaid
NV002416111Medicaid