Provider Demographics
NPI:1912798067
Name:SYLVAN, BRANDON CHASE
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:CHASE
Last Name:SYLVAN
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 1:714 SHAMROCK RD
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-2022
Mailing Address - Country:US
Mailing Address - Phone:402-981-6296
Mailing Address - Fax:
Practice Address - Street 1:714 SHAMROCK RD
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2022
Practice Address - Country:US
Practice Address - Phone:402-981-6296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant