Provider Demographics
NPI:1164673786
Name:HAMPSHIRE, BRANDI JO
Entity Type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:JO
Last Name:HAMPSHIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:JO
Other - Last Name:HIXENBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:166 RACHELLE PL
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:TN
Mailing Address - Zip Code:38544-2000
Mailing Address - Country:US
Mailing Address - Phone:931-265-9373
Mailing Address - Fax:
Practice Address - Street 1:166 RACHELLE PL
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:TN
Practice Address - Zip Code:38544-2000
Practice Address - Country:US
Practice Address - Phone:931-265-9373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2019-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ045472Medicaid