Provider Demographics
NPI:1578261434
Name:FARRELL, BRANDI N (AGPCNP)
Entity Type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:N
Last Name:FARRELL
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 ST CROIX LN APT 308
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7460
Mailing Address - Country:US
Mailing Address - Phone:919-943-9690
Mailing Address - Fax:
Practice Address - Street 1:4025 ST CROIX LN APT 308
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7460
Practice Address - Country:US
Practice Address - Phone:919-943-9690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC217675163W00000X
NCFARR-H0UNO363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse