Provider Demographics
NPI:1912627753
Name:HARPER, BRANDI MARIE (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:MARIE
Last Name:HARPER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10072 COUNTY ROAD 118
Mailing Address - Street 2:
Mailing Address - City:BULLARD
Mailing Address - State:TX
Mailing Address - Zip Code:75757-8335
Mailing Address - Country:US
Mailing Address - Phone:903-504-1981
Mailing Address - Fax:
Practice Address - Street 1:1402 RICE RD STE 100
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3230
Practice Address - Country:US
Practice Address - Phone:903-630-7691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1184012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1184012OtherTEXAS BON