Individual
MR. BRANDON CHARLES BATHRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN-BSN
Contact information
Practice address
139 CENTRAL AVE, WELLSBORO, PA 16901-1869
(607) 425-1786
Mailing address
139 CENTRAL AVE, WELLSBORO, PA 16901-1869
(607) 425-1786
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
153131
PA
163W00000X
Registered Nurse
Primary
603096
NY
163W00000X
Registered Nurse
RN597760
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
603096
NEW YORK STATE DEPARTMENT OF HEALTH
NY
01
—
RN597760
PENNSYLVANIA DEPARTMENT OF HEALTH
PA
Enumeration date
08/11/2015
Last updated
08/11/2015
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