Provider Demographics
NPI:1801403399
Name:PEABODY, BRANDY MARIE (CNM)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:MARIE
Last Name:PEABODY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6224 STEEPLECHASE PKWY
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43571-9022
Mailing Address - Country:US
Mailing Address - Phone:419-467-0342
Mailing Address - Fax:
Practice Address - Street 1:2751 BAY PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-4922
Practice Address - Country:US
Practice Address - Phone:419-690-7596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife