Provider Demographics
NPI:1356713614
Name:BRANCH, MARION MICHELLE (HHA)
Entity type:Individual
Prefix:MRS
First Name:MARION
Middle Name:MICHELLE
Last Name:BRANCH
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:MRS
Other - First Name:MARION
Other - Middle Name:
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4821 JAY ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3754
Mailing Address - Country:US
Mailing Address - Phone:202-374-6093
Mailing Address - Fax:
Practice Address - Street 1:4821 JAY ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3754
Practice Address - Country:US
Practice Address - Phone:202-374-6093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11616374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide