Provider Demographics
NPI:1376687582
Name:BRATCHER, JAN R (DPH)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:R
Last Name:BRATCHER
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 SUNBURST DR
Mailing Address - Street 2:
Mailing Address - City:MC MINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-3051
Mailing Address - Country:US
Mailing Address - Phone:931-473-0509
Mailing Address - Fax:
Practice Address - Street 1:835 SMITHVILLE HWY
Practice Address - Street 2:
Practice Address - City:MC MINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-1669
Practice Address - Country:US
Practice Address - Phone:931-473-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4122183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist