Provider Demographics
NPI:1972375699
Name:TARN, BRANICE (LPN)
Entity type:Individual
Prefix:
First Name:BRANICE
Middle Name:
Last Name:TARN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 HUNTLEY RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-3803
Mailing Address - Country:US
Mailing Address - Phone:267-688-3228
Mailing Address - Fax:
Practice Address - Street 1:351 HUNTLEY RD
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-3803
Practice Address - Country:US
Practice Address - Phone:267-688-3228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN320123164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse