Provider Demographics
NPI:1154084408
Name:FAUCETTE, BRANDY MICHELLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:MICHELLE
Last Name:FAUCETTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 ROLLING RD
Mailing Address - Street 2:
Mailing Address - City:HAW RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:27258-9690
Mailing Address - Country:US
Mailing Address - Phone:336-512-5854
Mailing Address - Fax:
Practice Address - Street 1:704 ROLLING RD
Practice Address - Street 2:
Practice Address - City:HAW RIVER
Practice Address - State:NC
Practice Address - Zip Code:27258-9690
Practice Address - Country:US
Practice Address - Phone:336-512-5854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFAUC-4VV2Y363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily