Provider Demographics
NPI:1619856077
Name:WEGERLE, BRANDI PATRICIA (NP-S, RN, BSN)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:PATRICIA
Last Name:WEGERLE
Suffix:
Gender:F
Credentials:NP-S, RN, BSN
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:PATRICIA
Other - Last Name:WEGERLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-S, RN
Mailing Address - Street 1:40 CORINTHIAN AVE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-6501
Mailing Address - Country:US
Mailing Address - Phone:760-899-2523
Mailing Address - Fax:
Practice Address - Street 1:40 CORINTHIAN AVE
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-6501
Practice Address - Country:US
Practice Address - Phone:760-899-2523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT206376163W00000X, 363LF0000X
CA95269675163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse