Provider Demographics
NPI:1043617855
Name:KOHN, BRANDI LEE (FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:BRANDI
Middle Name:LEE
Last Name:KOHN
Suffix:
Gender:F
Credentials:FNP-C
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 7987
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36670-0987
Mailing Address - Country:US
Mailing Address - Phone:251-633-0573
Mailing Address - Fax:251-633-7367
Practice Address - Street 1:141 TUSCALOOSA ST.
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3422
Practice Address - Country:US
Practice Address - Phone:251-433-3344
Practice Address - Fax:251-433-4052
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-122336363L00000X
AL1122336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03988710OtherMS MEDICAID
AL221585Medicaid
AL222626Medicaid
ALP01472078OtherRR MEDICARE
AL5116736OtherAETNA
ALZ94090OtherVIVA HEALTH
AL213489Medicaid
AL511-95733OtherBCBS
AL512-06695OtherBCBS
AL102I503889OtherMEDICARE
AL171394Medicaid
AL214121Medicaid
AL511-58768OtherBCBS
AL512-06694OtherBCBS
AL5329049OtherUHC