1992299150 NPI number — MRS. BRANDI NICOLE PLEMING FNP

Table of content: MRS. BRANDI NICOLE PLEMING FNP (NPI 1992299150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992299150 NPI number — MRS. BRANDI NICOLE PLEMING FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PLEMING
Provider First Name:
BRANDI
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
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:
1992299150
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1705
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUGUSTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30903-1705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-774-7263
Provider Business Mailing Address Fax Number:
706-774-7230

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3515 RICHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AIKEN
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-642-2626
Provider Business Practice Location Address Fax Number:
803-648-2960
Provider Enumeration Date:
06/20/2018

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:  RN217363 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 22059 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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