Provider Demographics
NPI:1427507243
Name:KIRKPATRICK, BRANDY MICHEAL (AGACNP)
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:MICHEAL
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 LYONS BRIDGE RD SW
Mailing Address - Street 2:
Mailing Address - City:CAVE SPRING
Mailing Address - State:GA
Mailing Address - Zip Code:30124-3130
Mailing Address - Country:US
Mailing Address - Phone:770-324-0735
Mailing Address - Fax:
Practice Address - Street 1:501 REDMOND RD NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1415
Practice Address - Country:US
Practice Address - Phone:706-291-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2016-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1001126335363LA2100X
GARN160060363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care