Provider Demographics
NPI:1902537491
Name:BRATTON, AMANDA RENEE (CLD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:RENEE
Last Name:BRATTON
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 LEGENDS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3481
Mailing Address - Country:US
Mailing Address - Phone:281-832-0188
Mailing Address - Fax:
Practice Address - Street 1:3311 LEGENDS CREEK DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-3481
Practice Address - Country:US
Practice Address - Phone:281-832-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5-201611374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty