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NPI Code Detail

MEDICARE: JAY BRANNAN RN

MEDICARE: JAY BRANNAN RN
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
1163WH0200XHome Health Registered NurseR036821SD

General Provider Information

NPI Number : 1407667819
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY BRANNAN RN
Provider Business Mailing Address
First Line : 34 DEER RUN CIR
Second Line :
City : MCCOOK LAKE
State : SD
Zip : 57049-4082
Country : US
Telephone Number : 605-323-5453
Fax Number :
Provider Business Practice Location Address
First Line : 380 W ANCHOR DR
Second Line :
City : DAKOTA DUNES
State : SD
Zip : 57049-5273
Country : US
Telephone Number : 605-323-5453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2025
Last Update Date : 01/15/2025

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