Provider Demographics
NPI:1588900237
Name:GEORGE, BRANDY CB (FNP)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:CB
Last Name:GEORGE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 OXFORD DR STE 202
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2351
Mailing Address - Country:US
Mailing Address - Phone:207-385-5723
Mailing Address - Fax:
Practice Address - Street 1:400 OXFORD DR STE 202
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2351
Practice Address - Country:US
Practice Address - Phone:412-380-5026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-28
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP121119363LF0000X
PASP026942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily