Provider Demographics
NPI:1508129420
Name:BRANSON, DORIS LORRAINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:LORRAINE
Last Name:BRANSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7240 SE 172 HAZELWOOD LOOP
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162
Mailing Address - Country:US
Mailing Address - Phone:352-751-1371
Mailing Address - Fax:352-751-0371
Practice Address - Street 1:7240 SE 172 HAZELWOOD LOOP
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5363
Practice Address - Country:US
Practice Address - Phone:352-751-1371
Practice Address - Fax:352-751-1371
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9259458163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse