Provider Demographics
NPI:1710233184
Name:CARBONIE, BRANDI (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:
Last Name:CARBONIE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:KADZIOLKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:2547 JOHN HAWKINS PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3554
Mailing Address - Country:US
Mailing Address - Phone:205-988-8311
Mailing Address - Fax:205-988-3590
Practice Address - Street 1:1919 KENTUCKY AVE STE 113
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1813
Practice Address - Country:US
Practice Address - Phone:205-971-1515
Practice Address - Fax:205-971-1520
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-087541171M00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No171M00000XOther Service ProvidersCase Manager/Care Coordinator