Provider Demographics
NPI:1528363454
Name:LI MANDRI, BRIANN (MSN, PMHNP)
Entity type:Individual
Prefix:
First Name:BRIANN
Middle Name:
Last Name:LI MANDRI
Suffix:
Gender:F
Credentials:MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3348 MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-5013
Mailing Address - Country:US
Mailing Address - Phone:501-519-3660
Mailing Address - Fax:501-521-1001
Practice Address - Street 1:3348 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-5013
Practice Address - Country:US
Practice Address - Phone:501-443-3818
Practice Address - Fax:501-521-1001
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR228677363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health