Provider Demographics
NPI:1083777999
Name:BRANDT, LYNN MICHELE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:MICHELE
Last Name:BRANDT
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:970 JOE FRANK HARRIS PKWY SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-2159
Mailing Address - Country:US
Mailing Address - Phone:770-382-4898
Mailing Address - Fax:770-382-4964
Practice Address - Street 1:970 JOE FRANK HARRIS PKWY SE
Practice Address - Street 2:SUITE 100
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2159
Practice Address - Country:US
Practice Address - Phone:770-382-4898
Practice Address - Fax:770-382-4964
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2014-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA105979363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner