Provider Demographics
NPI:1659677540
Name:STEPHENS, BRANDI BARBER (FNP-C)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:BARBER
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9460 MILBANK DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-3867
Mailing Address - Country:US
Mailing Address - Phone:318-658-4114
Mailing Address - Fax:
Practice Address - Street 1:9460 MILBANK DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-3867
Practice Address - Country:US
Practice Address - Phone:318-658-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-10
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06859363LF0000X, 363LF0000X
TX737218163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2317156Medicaid
LA2317156Medicaid