Provider Demographics
NPI:1184681934
Name:BRANTLEY, MERRY A (AUD)
Entity type:Individual
Prefix:DR
First Name:MERRY
Middle Name:A
Last Name:BRANTLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE AYRES CIRCLE, BUILDING H-1, PORTSMOUTH NAVAL SHIPYD
Mailing Address - Street 2:NAVAL HEALTH CARE NEW ENGLAND, BRANCH CLINIC
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03804-5000
Mailing Address - Country:US
Mailing Address - Phone:207-438-2081
Mailing Address - Fax:207-438-1754
Practice Address - Street 1:ONE AYRES CIRCLE, BUILDING H-1, PORTSMOUTH NAVAL SHIPYD
Practice Address - Street 2:NAVAL HEALTH CARE NEW ENGLAND, BRANCH CLINIC
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03804-5000
Practice Address - Country:US
Practice Address - Phone:207-438-2081
Practice Address - Fax:207-438-1754
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHA404231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH020473740OtherHUMANA CHOICE CARE
NH020473740OtherUNITED HEALTHCARE
NH020473740OtherGREAT WEST HEALTHCARE
NH2924917OtherCIGNA
NH30432258Medicaid
NH73Y002891NH01OtherANTHEM
NH020473740OtherTRICARE
NH640004535OtherRAILROAD MEDICARE
NHAA14036OtherHARVARD PILGRIM
NH020473740OtherHEALTHCARE VALUE MGMT
NH020473740OtherPRIVATE HEALTHCARE SYSTEM
NH2512656OtherAETNA
NH30432258Medicaid