Healthcare Provider Details

I. General information

NPI: 1063249886
Provider Name (Legal Business Name): KATHRYN J BRAMMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6194 BEAUMONT SQ
LEWIS CENTER OH
43035-8157
US

IV. Provider business mailing address

1140 LITTLE BEAR LOOP
LEWIS CENTER OH
43035-8506
US

V. Phone/Fax

Practice location:
  • Phone: 614-203-5467
  • Fax:
Mailing address:
  • Phone: 740-568-8326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberRN647096
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: