Provider Demographics
NPI:1073317566
Name:BRANDSER, NICHOLAS RYAN
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:RYAN
Last Name:BRANDSER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 E 6TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2969
Mailing Address - Country:US
Mailing Address - Phone:513-207-0775
Mailing Address - Fax:
Practice Address - Street 1:4777 E GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2814
Practice Address - Country:US
Practice Address - Phone:513-686-5446
Practice Address - Fax:513-686-6868
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program