Provider Demographics
NPI:1972355972
Name:WHITE, BRANDI (CD)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6958 VICKSBURG LN
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-9406
Mailing Address - Country:US
Mailing Address - Phone:423-316-0456
Mailing Address - Fax:
Practice Address - Street 1:6958 VICKSBURG LN
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:TN
Practice Address - Zip Code:37341-9406
Practice Address - Country:US
Practice Address - Phone:423-316-0456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0128458374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty