Provider Demographics
NPI:1063802346
Name:BARTHOLOMEW, BRANDY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-2011
Mailing Address - Country:US
Mailing Address - Phone:731-968-8182
Mailing Address - Fax:731-968-8185
Practice Address - Street 1:157 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-2011
Practice Address - Country:US
Practice Address - Phone:731-968-8182
Practice Address - Fax:731-968-8185
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19618363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily