Provider Demographics
NPI:1194793489
Name:BRANDON, VICKIE LOU (DNP, FNP, CNS)
Entity type:Individual
Prefix:DR
First Name:VICKIE
Middle Name:LOU
Last Name:BRANDON
Suffix:
Gender:F
Credentials:DNP, FNP, CNS
Other - Prefix:
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Mailing Address - Street 1:108 WATLINGTON DR # 1A
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-4200
Mailing Address - Country:US
Mailing Address - Phone:571-314-6136
Mailing Address - Fax:920-706-3788
Practice Address - Street 1:300 RINGGOLD INDUSTRIAL PKWY
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-5548
Practice Address - Country:US
Practice Address - Phone:571-314-6136
Practice Address - Fax:920-706-3788
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0240955364SP0809X
VA0024101739363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult