Provider Demographics
NPI:1649748096
Name:BRANDON, CYNTHIA MOORE (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MOORE
Last Name:BRANDON
Suffix:
Gender:F
Credentials:APRN, FNP-BC
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:165 BLUE RIDGE OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4431
Mailing Address - Country:US
Mailing Address - Phone:706-946-5607
Mailing Address - Fax:706-374-7628
Practice Address - Street 1:1008 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:GA
Practice Address - Zip Code:30705-2118
Practice Address - Country:US
Practice Address - Phone:706-517-2273
Practice Address - Fax:706-517-2469
Is Sole Proprietor?:No
Enumeration Date:2018-11-04
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA226133363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner