Provider Demographics
NPI:1124313549
Name:GIRMANN, BRANDIE VALENCIA-MOORE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:BRANDIE
Middle Name:VALENCIA-MOORE
Last Name:GIRMANN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:BRANDIE
Other - Middle Name:VALENCIA
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:235 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-4429
Mailing Address - Country:US
Mailing Address - Phone:937-743-9474
Mailing Address - Fax:937-743-9475
Practice Address - Street 1:235 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-4429
Practice Address - Country:US
Practice Address - Phone:937-743-9474
Practice Address - Fax:937-743-9475
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.002863363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant