Provider Demographics
NPI:1881365971
Name:BRAMMER, ELIZABETH (PA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BRAMMER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 OLD RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-3454
Mailing Address - Country:US
Mailing Address - Phone:434-791-4122
Mailing Address - Fax:
Practice Address - Street 1:705 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1803
Practice Address - Country:US
Practice Address - Phone:434-791-4122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110008128363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant