Provider Demographics
NPI:1598453615
Name:THOMAS, BRANDY SHANELL
Entity Type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:SHANELL
Last Name:THOMAS
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 1:7126 HIRSCH DR APT 234
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-4041
Mailing Address - Country:US
Mailing Address - Phone:513-486-1999
Mailing Address - Fax:
Practice Address - Street 1:6469 MONTGOMERY RD APT 77126
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-1540
Practice Address - Country:US
Practice Address - Phone:513-486-8199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide