Provider Demographics
NPI:1649410234
Name:THOMASSON, BRANDI NICOLE (RN)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:NICOLE
Last Name:THOMASSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1082 VILLAGE SQUARE DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-5332
Mailing Address - Country:US
Mailing Address - Phone:334-222-5558
Mailing Address - Fax:334-222-1078
Practice Address - Street 1:1082 VILLAGE SQUARE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5332
Practice Address - Country:US
Practice Address - Phone:334-222-5558
Practice Address - Fax:334-222-1078
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-093247163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse