Provider Demographics
NPI:1477065803
Name:CARMICAL, BRANDI (APRN)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:CARMICAL
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 1:279 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-1973
Mailing Address - Country:US
Mailing Address - Phone:606-487-9505
Mailing Address - Fax:606-436-0071
Practice Address - Street 1:279 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-1973
Practice Address - Country:US
Practice Address - Phone:606-487-9505
Practice Address - Fax:606-436-0071
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011847363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily