Provider Demographics
NPI:1891429023
Name:HERRERA, BRANDEE JEAN
Entity Type:Individual
Prefix:
First Name:BRANDEE
Middle Name:JEAN
Last Name:HERRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 SAINT CROIX LN APT 1332
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-3527
Mailing Address - Country:US
Mailing Address - Phone:307-760-7022
Mailing Address - Fax:
Practice Address - Street 1:4645 SAINT CROIX LN APT 1332
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-3527
Practice Address - Country:US
Practice Address - Phone:307-760-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9435792163W00000X
FL11021356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse