MEDICARE: MEGHAN LEIGH BRANNING PA-C

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	363A00000X	Physician Assistant	PA9110029	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629513163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN LEIGH BRANNING PA-C

Provider Business Mailing Address
First Line	:	3 SHIRCLIFF WAY
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4757
Country	:	US
Telephone Number	:	904-308-6630
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 SHIRCLIFF WAY STE 625
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4776
Country	:	US
Telephone Number	:	904-308-6900
Fax Number	:

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

Provider Enumeration Date	:	12/19/2016
Last Update Date	:	11/19/2019

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Directions to “ MEGHAN LEIGH BRANNING PA-C” Practice Location

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