MEDICARE: BRANDICE EVANS

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	172A00000X	Driver

General Provider Information

NPI Number	:	1639037310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDICE EVANS

Provider Business Mailing Address
First Line	:	5598 CARLTON DR
Second Line	:
City	:	BEDFORD HTS
State	:	OH
Zip	:	44146-2301
Country	:	US
Telephone Number	:	800-617-6733
Fax Number	:

Provider Business Practice Location Address
First Line	:	5598 CARLTON DR
Second Line	:
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-2301
Country	:	US
Telephone Number	:	800-617-6733
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ BRANDICE EVANS ” Practice Location

Language	Start Address	Practice Location

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