Provider Demographics
NPI:1134713191
Name:BRANNON, MARGARET (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:BRANNON
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BEECHWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-1601
Mailing Address - Country:US
Mailing Address - Phone:864-908-9492
Mailing Address - Fax:
Practice Address - Street 1:101 BEECHWOOD CT
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-1601
Practice Address - Country:US
Practice Address - Phone:864-908-9492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-21
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC232542163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty