Provider Demographics
NPI:1215217328
Name:PIERCE, BRANDY GAYLE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:GAYLE
Last Name:PIERCE
Suffix:
Gender:F
Credentials: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 579
Mailing Address - Street 2:
Mailing Address - City:MUNFORDVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42765-0579
Mailing Address - Country:US
Mailing Address - Phone:270-524-7231
Mailing Address - Fax:270-524-7415
Practice Address - Street 1:117 WEST SOUTH ST.
Practice Address - Street 2:
Practice Address - City:MUNFORDVILLE
Practice Address - State:KY
Practice Address - Zip Code:42765
Practice Address - Country:US
Practice Address - Phone:270-524-7231
Practice Address - Fax:270-524-7415
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1096234163W00000X
KY3007124363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000729939OtherANTHEM
KYK015640Medicare PIN