Provider Demographics
NPI:1750028320
Name:WARGACKI, BRANDI (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:
Last Name:WARGACKI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 UPTOWN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3537
Mailing Address - Country:US
Mailing Address - Phone:972-977-8512
Mailing Address - Fax:
Practice Address - Street 1:294 UPTOWN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3537
Practice Address - Country:US
Practice Address - Phone:972-817-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1087155363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily