Provider Demographics
NPI:1699316950
Name:BARRETT, BRANDY L (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:L
Last Name:BARRETT
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SCHEELER RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1014
Mailing Address - Country:US
Mailing Address - Phone:410-778-5783
Mailing Address - Fax:410-778-7344
Practice Address - Street 1:300 SCHEELER RD
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1014
Practice Address - Country:US
Practice Address - Phone:410-778-5783
Practice Address - Fax:410-778-7344
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR196694163WP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health