Provider Demographics
NPI:1528850369
Name:NOBLE, BRANDON L
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:L
Last Name:NOBLE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25124 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:VENETA
Mailing Address - State:OR
Mailing Address - Zip Code:97487-9707
Mailing Address - Country:US
Mailing Address - Phone:541-543-5679
Mailing Address - Fax:
Practice Address - Street 1:25124 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:VENETA
Practice Address - State:OR
Practice Address - Zip Code:97487-9707
Practice Address - Country:US
Practice Address - Phone:541-543-5679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health