Provider Demographics
NPI:1326875824
Name:KITTRELL, BRANDY
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:KITTRELL
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 1:2909 MILL CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-2201
Mailing Address - Country:US
Mailing Address - Phone:240-676-5682
Mailing Address - Fax:
Practice Address - Street 1:203 M ST SW # 210
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-3638
Practice Address - Country:US
Practice Address - Phone:240-676-5682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant