Provider Demographics
NPI:1568042836
Name:BRANT, RACHAEL MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:MARIE
Last Name:BRANT
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 1:118 SHAELI DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-1805
Mailing Address - Country:US
Mailing Address - Phone:814-652-3220
Mailing Address - Fax:
Practice Address - Street 1:118 SHAELI DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-1805
Practice Address - Country:US
Practice Address - Phone:814-652-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN291441164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse