Provider Demographics
NPI:1730057019
Name:ALSTON, BRANDY NICOLE
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:NICOLE
Last Name:ALSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4958 OLDE COVENTRY RD W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-2658
Mailing Address - Country:US
Mailing Address - Phone:614-678-2901
Mailing Address - Fax:614-678-2901
Practice Address - Street 1:4958 OLDE COVENTRY RD W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-2658
Practice Address - Country:US
Practice Address - Phone:614-678-2901
Practice Address - Fax:614-678-2901
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty