Provider Demographics
NPI:1598163016
Name:BRANDSTETTER, CARRIE LYNN (ACNP)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:LYNN
Last Name:BRANDSTETTER
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Gender:F
Credentials:ACNP
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-747-1206
Mailing Address - Fax:314-454-8687
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:DIV IM INFECTIOUS DISEASE
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-747-1206
Practice Address - Fax:314-454-8687
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2024-04-25
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Provider Licenses
StateLicense IDTaxonomies
MO2014042022363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420026041Medicaid