Provider Demographics
NPI:1891559274
Name:WHITE, BRANDI R (MSN, CCRN, ACCNS-N)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:R
Last Name:WHITE
Suffix:
Gender:F
Credentials:MSN, CCRN, ACCNS-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7049 BARRANCA DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9697
Mailing Address - Country:US
Mailing Address - Phone:916-761-9961
Mailing Address - Fax:
Practice Address - Street 1:7049 BARRANCA DR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9697
Practice Address - Country:US
Practice Address - Phone:916-761-9961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5106364SN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SN0000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeonatal