Provider Demographics
NPI:1659629947
Name:BRANSON, ELYSIA-MARIE (BVMS)
Entity Type:Individual
Prefix:MISS
First Name:ELYSIA-MARIE
Middle Name:
Last Name:BRANSON
Suffix:
Gender:F
Credentials:BVMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 N LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-4504
Mailing Address - Country:US
Mailing Address - Phone:540-437-1980
Mailing Address - Fax:540-437-1982
Practice Address - Street 1:910 N LIBERTY ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-4504
Practice Address - Country:US
Practice Address - Phone:540-437-1980
Practice Address - Fax:540-437-1982
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0301203313174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian