Provider Demographics
NPI:1518522614
Name:BRANSTITER, MEGAN (BSN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:BRANSTITER
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 BREWSTER LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8746
Mailing Address - Country:US
Mailing Address - Phone:828-460-4022
Mailing Address - Fax:
Practice Address - Street 1:160 CYPRESS POINT PKWY STE B201
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-8442
Practice Address - Country:US
Practice Address - Phone:386-986-6498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9510134163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNAOtherNA