Provider Demographics
NPI:1992571442
Name:SCOTT, BRANDI (FNP)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:FAISON
Mailing Address - State:NC
Mailing Address - Zip Code:28341-0187
Mailing Address - Country:US
Mailing Address - Phone:910-267-1942
Mailing Address - Fax:855-996-9090
Practice Address - Street 1:110 EASTWOOD DR
Practice Address - Street 2:
Practice Address - City:WALLACE
Practice Address - State:NC
Practice Address - Zip Code:28466-9201
Practice Address - Country:US
Practice Address - Phone:910-285-2330
Practice Address - Fax:910-320-8429
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019813363LF0000X
NC262065163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care