Doctor Name: | BRANDIE LYNNE METHENY |
NPI Number: | 1255576195 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 55626 |
Business Practice Address: | 1513 Harrison Ave Suite 18 Elkins, WV - 262413356 |
Business Phone Number: | 3046370180 |
Business Fax Number: | 3046371004 |
Mailing Address: | 1513 Harrison Ave, Suite 18 ELKINS |
State: | WV |
Postal Code: | 262413356 |
Phone Number: | 3046370180 |
Fax Number: | 3046371004 |
NPI Enumeration Date: | 12/06/2008 |
NPI Last Update Date: | 12/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 55626 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |