Provider Demographics
NPI:1114725900
Name:ETTER, BRANDY ALANA (RN CMGT-BC)
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:ALANA
Last Name:ETTER
Suffix:
Gender:
Credentials:RN CMGT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:FORT EUSTIS
Mailing Address - State:VA
Mailing Address - Zip Code:23604-1373
Mailing Address - Country:US
Mailing Address - Phone:757-314-7974
Mailing Address - Fax:757-314-7717
Practice Address - Street 1:576 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:FORT EUSTIS
Practice Address - State:VA
Practice Address - Zip Code:23604-1373
Practice Address - Country:US
Practice Address - Phone:757-314-7974
Practice Address - Fax:757-314-7717
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001168146163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management