Provider Demographics
NPI:1972515310
Name:LISTI, BRANDI BARR (NP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:BARR
Last Name:LISTI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:C
Other - Last Name:BARR LISTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0277
Mailing Address - Country:US
Mailing Address - Phone:409-772-3350
Mailing Address - Fax:
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0277
Practice Address - Country:US
Practice Address - Phone:409-772-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628290363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics