Provider Demographics
NPI:1851148530
Name:CLAYTON, BRANDY MICHELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:MICHELLE
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 STEEN ST
Mailing Address - Street 2:
Mailing Address - City:FORT SCOTT
Mailing Address - State:KS
Mailing Address - Zip Code:66701-1957
Mailing Address - Country:US
Mailing Address - Phone:620-768-9893
Mailing Address - Fax:
Practice Address - Street 1:601 STEEN ST
Practice Address - Street 2:
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701-1957
Practice Address - Country:US
Practice Address - Phone:620-768-9893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-83108-051363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily