Provider Demographics
NPI:1386911683
Name:BRANFORD, KEVIN (BSN, RN)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:BRANFORD
Suffix:
Gender:M
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MASTERS CIR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3746
Mailing Address - Country:US
Mailing Address - Phone:646-302-2380
Mailing Address - Fax:
Practice Address - Street 1:54 MASTERS CIR
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3746
Practice Address - Country:US
Practice Address - Phone:646-302-2380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY635239-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse