1851488753 NPI number — BRANDY RENEE PARSLEY FNP-C

Table of content: BRANDY RENEE PARSLEY FNP-C (NPI 1851488753)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851488753 NPI number — BRANDY RENEE PARSLEY FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARSLEY
Provider First Name:
BRANDY
Provider Middle Name:
RENEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851488753
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
713 NOMAD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPICEWOOD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78669-1496
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-491-4830
Provider Business Mailing Address Fax Number:
866-250-8731

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
713 NOMAD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPICEWOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78669-1496
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-491-4830
Provider Business Practice Location Address Fax Number:
866-250-8731
Provider Enumeration Date:
10/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  629913 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: AP113680 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8Y2008 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P00437899 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 191034101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".