Provider Demographics
NPI:1104304583
Name:STUFFT, BRANDY JO (APRN, CNP)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:JO
Last Name:STUFFT
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:JO
Other - Last Name:EBERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10825 WEIMER DR SE
Mailing Address - Street 2:
Mailing Address - City:EAST CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44730-9738
Mailing Address - Country:US
Mailing Address - Phone:330-473-0226
Mailing Address - Fax:
Practice Address - Street 1:2011 GLAMORGAN ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-2709
Practice Address - Country:US
Practice Address - Phone:330-823-3951
Practice Address - Fax:330-823-3996
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023050363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily