Provider Demographics
NPI:1609178714
Name:LAURENZI, BRANDY E (NP)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:E
Last Name:LAURENZI
Suffix:
Gender:F
Credentials:NP
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 130
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-0003
Mailing Address - Country:US
Mailing Address - Phone:334-567-3309
Mailing Address - Fax:334-567-9007
Practice Address - Street 1:41 CAMBRIDGE CT
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36093-1261
Practice Address - Country:US
Practice Address - Phone:334-567-3309
Practice Address - Fax:334-567-9007
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-094996363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care