Provider Demographics
NPI:1396347274
Name:THOMSEN, BRANDI ELIZABETH (NC60463036)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:ELIZABETH
Last Name:THOMSEN
Suffix:
Gender:F
Credentials:NC60463036
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6824 150TH ST SW APT 9
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98439-2434
Mailing Address - Country:US
Mailing Address - Phone:253-359-8304
Mailing Address - Fax:
Practice Address - Street 1:92 PARK AVE NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-5941
Practice Address - Country:US
Practice Address - Phone:253-432-3145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC.60463036376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide