MEDICARE: SHAUNA VANESSA BRATTON MED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor		KY

General Provider Information

NPI Number	:	1588873988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAUNA VANESSA BRATTON MED

Provider Business Mailing Address
First Line	:	3629 CHURCH ST
Second Line	:
City	:	COVINGTON
State	:	KY
Zip	:	41015-1430
Country	:	US
Telephone Number	:	859-581-8974
Fax Number	:

Provider Business Practice Location Address
First Line	:	3825 DIXIE HWY
Second Line	:
City	:	ELSMERE
State	:	KY
Zip	:	41018-1809
Country	:	US
Telephone Number	:	859-342-2551
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/26/2007

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