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General NPI Number Information
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NPI Number | 1477363026
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Entity Type | Individual
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Provider Name | BRANDA ELIZABETH PAGE MS, BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 434 WILDWOOD AVE
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City | JACKSON
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State | MI
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Zip | 49201-1148
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Country | US
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Telephone | 517-435-9352
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 732
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City | MICHIGAN CENTER
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State | MI
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Zip | 49254-0732
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Country | US
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Telephone | 254-535-6735
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 4704242044
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 4704242044
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704242044
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License Number State | MI
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