Provider Demographics
NPI:1427612217
Name:WILLETT, BRANDY (PHARMD)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:WILLETT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436A SUNDOG CT
Mailing Address - Street 2:
Mailing Address - City:EIELSON AFB
Mailing Address - State:AK
Mailing Address - Zip Code:99702-3104
Mailing Address - Country:US
Mailing Address - Phone:907-669-0386
Mailing Address - Fax:
Practice Address - Street 1:2436A SUNDOG CT
Practice Address - Street 2:
Practice Address - City:EIELSON AFB
Practice Address - State:AK
Practice Address - Zip Code:99702-3104
Practice Address - Country:US
Practice Address - Phone:907-669-0386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK139883183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist