Provider Demographics
NPI:1366236309
Name:BRANNON, SABRINA COLLEEN (LPN)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:COLLEEN
Last Name:BRANNON
Suffix:
Gender:
Credentials:LPN
Other - Prefix:MS
Other - First Name:SABRINA
Other - Middle Name:COLLEEN
Other - Last Name:BOYD-DURHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:4761 COUNTRY LN APT E48
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5895
Mailing Address - Country:US
Mailing Address - Phone:216-882-9596
Mailing Address - Fax:
Practice Address - Street 1:4761 COUNTRY LN APT E48
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5895
Practice Address - Country:US
Practice Address - Phone:216-882-9596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.156022.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse