Provider Demographics
NPI:1841790847
Name:BRANUM, LEEANN (RN)
Entity Type:Individual
Prefix:
First Name:LEEANN
Middle Name:
Last Name:BRANUM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 JANICE DR
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4832
Mailing Address - Country:US
Mailing Address - Phone:903-227-9771
Mailing Address - Fax:
Practice Address - Street 1:170 JANICE DR
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4832
Practice Address - Country:US
Practice Address - Phone:903-227-9771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX687598163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics