Provider Demographics
NPI:1114684420
Name:BRAND, SHONDA S (CRNP)
Entity type:Individual
Prefix:
First Name:SHONDA
Middle Name:S
Last Name:BRAND
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 GRIP DR
Mailing Address - Street 2:
Mailing Address - City:HAZEL GREEN
Mailing Address - State:AL
Mailing Address - Zip Code:35750-8791
Mailing Address - Country:US
Mailing Address - Phone:256-813-8115
Mailing Address - Fax:
Practice Address - Street 1:103 GRIP DR
Practice Address - Street 2:
Practice Address - City:HAZEL GREEN
Practice Address - State:AL
Practice Address - Zip Code:35750-8791
Practice Address - Country:US
Practice Address - Phone:256-813-8115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-157697163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine