Provider Demographics
NPI:1891060042
Name:MOBLEY, BRANDY L (LVN, IBCLC)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:L
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:LVN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5216
Mailing Address - Country:US
Mailing Address - Phone:325-200-3273
Mailing Address - Fax:
Practice Address - Street 1:2810 AVENUE C
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5216
Practice Address - Country:US
Practice Address - Phone:325-200-3273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11151668174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN