Provider Demographics
NPI:1528053329
Name:BRASFIELD, KENNETH HUBERT (PHARMD, BCPP)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:HUBERT
Last Name:BRASFIELD
Suffix:
Gender:M
Credentials:PHARMD, BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 SUMMERDEAN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBROOK
Mailing Address - State:VA
Mailing Address - Zip Code:24459-2039
Mailing Address - Country:US
Mailing Address - Phone:540-332-8121
Mailing Address - Fax:540-332-8065
Practice Address - Street 1:1301 RICHMOND AVE
Practice Address - Street 2:WESTERN STATE HOSPITAL
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-9146
Practice Address - Country:US
Practice Address - Phone:540-332-8121
Practice Address - Fax:540-332-8065
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020098241835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric