Provider Demographics
NPI:1427698836
Name:CASH, BRANDI DAWN (NP)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:DAWN
Last Name:CASH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 OVEN PARK DR STE 201
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-7958
Mailing Address - Country:US
Mailing Address - Phone:706-499-2920
Mailing Address - Fax:850-765-0118
Practice Address - Street 1:500 GORDON AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6646
Practice Address - Country:US
Practice Address - Phone:850-765-8623
Practice Address - Fax:850-765-0118
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11025470363L00000X
GAAG12190079363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN154966Medicaid