Provider Demographics
NPI:1750095147
Name:HEDRICK, BRANDY R
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:R
Last Name:HEDRICK
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 1:12112 CHAPIN RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44814-9614
Mailing Address - Country:US
Mailing Address - Phone:419-370-8141
Mailing Address - Fax:
Practice Address - Street 1:12112 CHAPIN RD
Practice Address - Street 2:
Practice Address - City:BERLIN HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44814-9614
Practice Address - Country:US
Practice Address - Phone:419-370-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174200000XOther Service ProvidersMeals