MEDICARE: ANGELA BRATTON

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	372600000X	Adult Companion
2	3747P1801X	Personal Care Attendant

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992178958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA BRATTON

Provider Business Mailing Address
First Line	:	1219 ROCKINGHAM DR
Second Line	:
City	:	CLINTON
State	:	MS
Zip	:	39056-3543
Country	:	US
Telephone Number	:	601-937-0012
Fax Number	:	601-510-9242

Provider Business Practice Location Address
First Line	:	1219 ROCKINGHAM DR
Second Line	:
City	:	CLINTON
State	:	MS
Zip	:	39056-3543
Country	:	US
Telephone Number	:	601-937-0012
Fax Number	:	601-510-9242

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

Provider Enumeration Date	:	11/12/2015
Last Update Date	:	11/12/2015

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Directions to “ ANGELA BRATTON ” Practice Location

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