Provider Demographics
NPI:1942803077
Name:JARRETT CALVERT, BRANDY A (RN)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:A
Last Name:JARRETT CALVERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BIG BUCK TRL
Mailing Address - Street 2:
Mailing Address - City:OLD FORT
Mailing Address - State:NC
Mailing Address - Zip Code:28762-6802
Mailing Address - Country:US
Mailing Address - Phone:716-481-5289
Mailing Address - Fax:
Practice Address - Street 1:3100 HWY 226 S
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-8741
Practice Address - Country:US
Practice Address - Phone:828-655-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC305640163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse