Provider Demographics
NPI:1568086031
Name:BRANTLEY, ANTARNISEAR
Entity Type:Individual
Prefix:MISS
First Name:ANTARNISEAR
Middle Name:
Last Name:BRANTLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 SCOTT ST SW APT 118
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-1814
Mailing Address - Country:US
Mailing Address - Phone:425-405-0377
Mailing Address - Fax:
Practice Address - Street 1:311 SCOTT ST SW APT 118
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-1814
Practice Address - Country:US
Practice Address - Phone:425-405-0377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy