Provider Demographics
NPI:1073013389
Name:CORNELIUS, BRANDY (ANRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:CORNELIUS
Suffix:
Gender:F
Credentials:ANRN, FNP-C
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:309 PATRICIAN DR
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-9412
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1725 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1402
Practice Address - Country:US
Practice Address - Phone:251-435-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-146782363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner