Provider Demographics
NPI:1598272189
Name:HAMLEN, BRANDIE (ARNP)
Entity Type:Individual
Prefix:
First Name:BRANDIE
Middle Name:
Last Name:HAMLEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 COUNTY ROAD 97
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:AL
Mailing Address - Zip Code:35966-5615
Mailing Address - Country:US
Mailing Address - Phone:256-608-8004
Mailing Address - Fax:
Practice Address - Street 1:6141 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1616
Practice Address - Country:US
Practice Address - Phone:423-899-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23695363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily