Provider Demographics
NPI:1184800690
Name:PARKER, BRANDY LEIGH (LPN)
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:LEIGH
Last Name:PARKER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 W ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:OH
Mailing Address - Zip Code:45067-1044
Mailing Address - Country:US
Mailing Address - Phone:513-988-9349
Mailing Address - Fax:
Practice Address - Street 1:715 W ABERDEEN DR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:OH
Practice Address - Zip Code:45067-1044
Practice Address - Country:US
Practice Address - Phone:513-988-9349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 121082164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSS093773OtherDRIVERS LICENSE