Provider Demographics
NPI:1114267135
Name:LASLEY, BRANDY JEAN (FNP-C APRN)
Entity Type:Individual
Prefix:MISS
First Name:BRANDY
Middle Name:JEAN
Last Name:LASLEY
Suffix:
Gender:F
Credentials:FNP-C APRN
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 73652
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0002
Mailing Address - Country:US
Mailing Address - Phone:859-313-2758
Mailing Address - Fax:859-276-5939
Practice Address - Street 1:2135 HIGHWAY 30 BYP
Practice Address - Street 2:STE 1
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-6139
Practice Address - Country:US
Practice Address - Phone:606-864-2179
Practice Address - Fax:606-864-7484
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007929363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily