Provider Demographics
NPI:1972365484
Name:BRANAM, WENDY M
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:M
Last Name:BRANAM
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 1:8 MONTGOMERY WAY APT 3
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-1448
Mailing Address - Country:US
Mailing Address - Phone:513-904-3491
Mailing Address - Fax:
Practice Address - Street 1:8 MONTGOMERY WAY APT 3
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:OH
Practice Address - Zip Code:45102-1448
Practice Address - Country:US
Practice Address - Phone:513-904-3491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant