Provider Demographics
NPI:1124876404
Name:BRADEN, KARRON R
Entity type:Individual
Prefix:
First Name:KARRON
Middle Name:R
Last Name:BRADEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4113 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-5066
Mailing Address - Country:US
Mailing Address - Phone:216-512-1463
Mailing Address - Fax:216-205-4724
Practice Address - Street 1:4113 E 71ST ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-5066
Practice Address - Country:US
Practice Address - Phone:216-512-1463
Practice Address - Fax:216-205-4724
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator