Provider Demographics
NPI:1326808395
Name:STALNAKER, BRANDI MARIE (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:MARIE
Last Name:STALNAKER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 BRADLEY AVE APT B
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5502
Mailing Address - Country:US
Mailing Address - Phone:318-419-0794
Mailing Address - Fax:
Practice Address - Street 1:44 VERSAILLES BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3960
Practice Address - Country:US
Practice Address - Phone:318-445-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA234772363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health