Provider Demographics
NPI:1568783645
Name:HYATT, BRANDI LEA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:LEA
Last Name:HYATT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:BRANDI
Other - Middle Name:LEA
Other - Last Name:HYATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:2024 2ND AVE N
Mailing Address - Street 2:UNIT 901
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-3732
Mailing Address - Country:US
Mailing Address - Phone:205-283-6545
Mailing Address - Fax:
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-283-6545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-12
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-099695363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily