Brenda Joan Brannon, LPTA
Individual provider Active NPI Physical Disabilities Residential Treatment Facility · Winnfield, LA
NPI 1154615086 · NPPES record last updated Oct 15, 2015
Key facts
- NPI
- 1154615086
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Disabilities Residential Treatment Facility 320700000X
- License
- 20558960 (TX)
- Practice address
- 116 Dogwood Dr
Winnfield, LA 71483-5000 - Phone
- (409) 594-4912
- Fax
- (409) 594-4912
- NPI assigned
- Jun 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20558960 | TX | MD | Physical Disabilities Residential Treatment Facility |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Disabilities Residential Treatment Facility | 320700000X | 20558960 | TX | Yes |
Addresses
Primary practice location
116 Dogwood Dr
Winnfield, LA 71483-5000
Mailing address
116 Dogwood Dr
Winnfield, LA 71483-5000
Phone (409) 594-4912
Other providers in Winnfield, LA
- Jennette Sepulvado Bergstedt
- Bio-Medical Applications of Louisiana, LLC
- David A Bish
- April Boyett
- Mary Sue Branch
- Sam C Brian Jr.
- Judith T Bridges
- Brookside Nursing & Rehabilitation Center LLC
- Jessica Shere' Brown
- Rosalie Cascabel Buraga
All providers in Winnfield, LA · Physical Disabilities Residential Treatment Facility in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.