Provider Demographics
NPI:1396017364
Name:NOAKES, BRANDY
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:NOAKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:
Other - Last Name:FERRARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IDMT
Mailing Address - Street 1:23641 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:BURNT CABINS
Mailing Address - State:PA
Mailing Address - Zip Code:17215-9437
Mailing Address - Country:US
Mailing Address - Phone:717-816-5730
Mailing Address - Fax:
Practice Address - Street 1:72ND AMDS/SGPF
Practice Address - Street 2:7050 AIR DEPOT BLVD, BLDG 1094
Practice Address - City:TINKER AFB
Practice Address - State:OK
Practice Address - Zip Code:73145-8102
Practice Address - Country:US
Practice Address - Phone:405-734-6626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians