Provider Demographics
NPI:1407502693
Name:BRABHAM, CLAUDIA (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:BRABHAM
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CANTRELL RD
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:SC
Mailing Address - Zip Code:29670-9105
Mailing Address - Country:US
Mailing Address - Phone:864-650-2114
Mailing Address - Fax:
Practice Address - Street 1:135 CANTRELL RD
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:SC
Practice Address - Zip Code:29670-9105
Practice Address - Country:US
Practice Address - Phone:864-650-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101963163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant