Provider Demographics
NPI:1881229474
Name:SCOTT, BRANDY L (APNP)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:L
Last Name:SCOTT
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:L
Other - Last Name:LYNCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:534 PEWAUKEE RD UNIT G
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-6549
Mailing Address - Country:US
Mailing Address - Phone:262-424-7054
Mailing Address - Fax:
Practice Address - Street 1:7330 W LAYTON AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-3849
Practice Address - Country:US
Practice Address - Phone:414-877-4570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI190582163W00000X
WI9937363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse