Provider Demographics
NPI:1104332543
Name:CAIN, BRANDY A (FNP-C)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:A
Last Name:CAIN
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:A
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1107 MEMORIAL DR STE G2
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-8662
Mailing Address - Country:US
Mailing Address - Phone:706-529-3072
Mailing Address - Fax:706-272-6077
Practice Address - Street 1:1107 MEMORIAL DR STE G2
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-8662
Practice Address - Country:US
Practice Address - Phone:706-529-3072
Practice Address - Fax:706-272-6077
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23506363LF0000X
GARN274399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily