Provider Demographics
NPI:1821776998
Name:MCKAY, BRANDY POOLE (RRT, AE-C)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:POOLE
Last Name:MCKAY
Suffix:
Gender:F
Credentials:RRT, AE-C
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:NICOLE
Other - Last Name:POOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRT
Mailing Address - Street 1:175 FOUNTAIN VW
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-2956
Mailing Address - Country:US
Mailing Address - Phone:318-518-0001
Mailing Address - Fax:
Practice Address - Street 1:175 FOUNTAIN VW
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-2956
Practice Address - Country:US
Practice Address - Phone:318-518-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARRT.200235227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered