Provider Demographics
NPI:1053133678
Name:BRANFORD, LATRICE RENEE
Entity type:Individual
Prefix:MRS
First Name:LATRICE
Middle Name:RENEE
Last Name:BRANFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6024 RED BANK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213-2225
Mailing Address - Country:US
Mailing Address - Phone:513-346-0962
Mailing Address - Fax:
Practice Address - Street 1:6024 RED BANK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-2225
Practice Address - Country:US
Practice Address - Phone:513-346-0962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH379345661000376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide