Individual
BRANDEN WAYNE RAIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
5913 ELDORADO AVE, LOUISVILLE, KY 40291-1350
(859) 559-5194
Mailing address
5913 ELDORADO AVE, LOUISVILLE, KY 40291-1350
(859) 559-5194
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
1159821
KY
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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