Provider Demographics
NPI:1316683808
Name:WENDI BRANDON APRN PMHNP-BC LLC
Entity type:Organization
Organization Name:WENDI BRANDON APRN PMHNP-BC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-302-6520
Mailing Address - Street 1:3032 ALVEY PARK DR W STE 200
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-2105
Mailing Address - Country:US
Mailing Address - Phone:270-314-2885
Mailing Address - Fax:
Practice Address - Street 1:3032 ALVEY PARK DR W STE 200
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-2105
Practice Address - Country:US
Practice Address - Phone:270-302-6520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2023-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty