Provider Demographics
NPI:1679879472
Name:BRANDI KAMMERER PLLC
Entity Type:Organization
Organization Name:BRANDI KAMMERER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMMERER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:405-688-9801
Mailing Address - Street 1:1601 SW 89TH ST STE F200
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6358
Mailing Address - Country:US
Mailing Address - Phone:405-688-9801
Mailing Address - Fax:405-688-9800
Practice Address - Street 1:1601 SW 89TH ST STE F200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6358
Practice Address - Country:US
Practice Address - Phone:405-688-9801
Practice Address - Fax:405-688-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR89215363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty