Provider Demographics
NPI:1841893500
Name:BRADEN, LAURA ELLEN
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ELLEN
Last Name:BRADEN
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 1:3898 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:OH
Mailing Address - Zip Code:44081-9568
Mailing Address - Country:US
Mailing Address - Phone:440-259-2756
Mailing Address - Fax:
Practice Address - Street 1:3898 OHIO ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:OH
Practice Address - Zip Code:44081-9568
Practice Address - Country:US
Practice Address - Phone:440-259-2756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care