Provider Demographics
NPI:1184261893
Name:JANE BRATTON
Entity type:Organization
Organization Name:JANE BRATTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-541-2129
Mailing Address - Street 1:2618 CORNELL DR NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-2710
Mailing Address - Country:US
Mailing Address - Phone:540-541-2129
Mailing Address - Fax:540-566-4388
Practice Address - Street 1:2618 CORNELL DR NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-2710
Practice Address - Country:US
Practice Address - Phone:540-541-2129
Practice Address - Fax:540-566-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care