Provider Demographics
NPI:1841584943
Name:KINNARD, BRANDY LEE (LVN)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:LEE
Last Name:KINNARD
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:LEE
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1000
Mailing Address - Country:US
Mailing Address - Phone:661-868-6601
Mailing Address - Fax:661-868-6666
Practice Address - Street 1:17635 INDUSTRIAL FARM RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-9520
Practice Address - Country:US
Practice Address - Phone:661-391-7845
Practice Address - Fax:661-391-7978
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA243244164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse