Doctor Name: | MRS. PAMELA SUE BRANDT |
NPI Number: | 1265523732 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | RN080658 NP |
Business Practice Address: | 7950 Martin Loop Fort Benning, GA - 319055647 |
Business Phone Number: | 7065443193 |
Business Fax Number: | 7065442736 |
Mailing Address: | 4774 Champions Way, COLUMBUS |
State: | GA |
Postal Code: | 319092074 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | RN080658 NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |