Provider Demographics
NPI:1962917401
Name:BRANFORD, KEVIN CHARLES (RNFA)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:CHARLES
Last Name:BRANFORD
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:MR
Other - First Name:KEVIN
Other - Middle Name:CHARLES
Other - Last Name:BRANFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RNFA
Mailing Address - Street 1:406 KENT AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-4324
Mailing Address - Country:US
Mailing Address - Phone:504-621-5540
Mailing Address - Fax:
Practice Address - Street 1:406 KENT AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-4324
Practice Address - Country:US
Practice Address - Phone:504-621-5540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN125011163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant