Individual
MICHELE D BRANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2 MEMORIAL DR STE 220, ALTON, IL 62002-6723
(618) 474-1723
Mailing address
2 MEMORIAL DR STE 220, ALTON, IL 62002-6723
(618) 474-1723
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002124
IL
363A00000X
Physician Assistant
2004005137
MO
Other
Enumeration date
08/01/2006
Last updated
06/24/2021
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