Provider Demographics
NPI:1255685517
Name:BRAND, KATHRYN WOLFF (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:WOLFF
Last Name:BRAND
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 MONTCLAIR ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1966
Mailing Address - Country:US
Mailing Address - Phone:205-599-1020
Mailing Address - Fax:205-599-1029
Practice Address - Street 1:790 MONTCLAIR ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1966
Practice Address - Country:US
Practice Address - Phone:205-599-1020
Practice Address - Fax:205-599-1029
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-116126363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health