Provider Demographics
NPI: | 1508305715 |
---|---|
Name: | ADKINS, BRANDI NICOLE (APRN FNP-C) |
Entity Type: | Individual |
Prefix: | MRS |
First Name: | BRANDI |
Middle Name: | NICOLE |
Last Name: | ADKINS |
Suffix: | |
Gender: | F |
Credentials: | APRN FNP-C |
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 21890 |
Mailing Address - Street 2: | |
Mailing Address - City: | BELFAST |
Mailing Address - State: | ME |
Mailing Address - Zip Code: | 04915-4115 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 502-907-0356 |
Mailing Address - Fax: | 502-919-9780 |
Practice Address - Street 1: | 255 CHURCH ST STE 101 |
Practice Address - Street 2: | |
Practice Address - City: | PIKEVILLE |
Practice Address - State: | KY |
Practice Address - Zip Code: | 41501-3476 |
Practice Address - Country: | US |
Practice Address - Phone: | 606-260-8613 |
Practice Address - Fax: | 859-977-2683 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2017-02-21 |
Last Update Date: | 2024-02-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
KY | 3011132 | 363LF0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
000001430455 | Other | ANTHEM PIN | |
6357800 | Other | UNITED HEALTHCARE | |
KY | 7100476600 | Medicaid | |
WV | 1508305715 | Medicaid | |
VA | 30016480430001 | Medicaid |