Provider Demographics
NPI:1437508868
Name:WASKEY, BRANDON (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:WASKEY
Suffix:
Gender:M
Credentials:FNP-BC
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 1547
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25326-1547
Mailing Address - Country:US
Mailing Address - Phone:304-347-1204
Mailing Address - Fax:
Practice Address - Street 1:3100 MACCORKLE AVE SE
Practice Address - Street 2:SUITE 700
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1223
Practice Address - Country:US
Practice Address - Phone:304-347-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV61274363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner