Provider Demographics
NPI:1730636978
Name:TREHERN, BRANDI ALESI (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:ALESI
Last Name:TREHERN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7987
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36670-0987
Mailing Address - Country:US
Mailing Address - Phone:251-633-0573
Mailing Address - Fax:
Practice Address - Street 1:2001 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3326
Practice Address - Country:US
Practice Address - Phone:251-433-3344
Practice Address - Fax:251-433-4052
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-102766363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL208000Medicaid
ALP01827227OtherRR MEDICARE
ALZ79239OtherVIVA HEALTH
AL102I505629OtherMEDICARE
AL213019Medicaid
AL511-85570OtherBCBS
AL204590Medicaid
AL6247749OtherUHC
MS02932569OtherMS MEDICAID
AL214141Medicaid
AL4582549OtherAETNA
AL511-85571OtherBCBS
AL193346Medicaid
AL511-85569OtherBCBS
AL512-05751OtherBCBS