Provider Demographics
NPI:1316617046
Name:HISLOP, BRANDI NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:NICOLE
Last Name:HISLOP
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4973 DEER PARK RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-6028
Mailing Address - Country:US
Mailing Address - Phone:940-682-1972
Mailing Address - Fax:
Practice Address - Street 1:4973 DEER PARK RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-6028
Practice Address - Country:US
Practice Address - Phone:940-682-1972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1054517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily