Provider Demographics
NPI:1063249886
Name:BRAMMER, KATHRYN J
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:J
Last Name:BRAMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 LITTLE BEAR LOOP
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8506
Mailing Address - Country:US
Mailing Address - Phone:740-568-8326
Mailing Address - Fax:
Practice Address - Street 1:6194 BEAUMONT SQ
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8157
Practice Address - Country:US
Practice Address - Phone:614-203-5467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN647096172A00000X
376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker