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General NPI Number Information
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NPI Number | 1366451775
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Entity Type | Individual
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Provider Name | DANIEL BRANNEN
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 301 GOVERNORS DR SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5123
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Country | US
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Telephone | 256-535-3100
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Fax | 256-534-1580
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Provider Business Mailing Address
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Address Line | 467 PINE GROVE RD
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City | MADISON
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State | AL
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Zip | 35757-8030
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Country | US
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Telephone | 256-830-8370
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Fax | 256-539-0689
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA308
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License Number State | AL
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