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NPI Code Detail

MEDICARE: ABIGAIL DAWN BRANDT

MEDICARE: ABIGAIL DAWN BRANDT
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1780476796
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL DAWN BRANDT
Provider Business Mailing Address
First Line : 6100 STATE ROUTE 753 SE
Second Line :
City : WASHINGTON COURT HOUSE
State : OH
Zip : 43160-9248
Country : US
Telephone Number : 740-505-3638
Fax Number :
Provider Business Practice Location Address
First Line : 1332 WOODMAN DR
Second Line :
City : DAYTON
State : OH
Zip : 45432-3439
Country : US
Telephone Number : 513-740-1001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2025
Last Update Date : 05/19/2025

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Directions to “ ABIGAIL DAWN BRANDT ” Practice Location

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