Provider Demographics
NPI:1669026456
Name:BARNETTE, BRANDON CHASE (FNP)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:CHASE
Last Name:BARNETTE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 DENISE LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-8850
Mailing Address - Country:US
Mailing Address - Phone:336-407-8931
Mailing Address - Fax:
Practice Address - Street 1:1825 DENISE LN
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-8850
Practice Address - Country:US
Practice Address - Phone:336-407-8931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCBARN-54G31I207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine