Provider Demographics
NPI:1992597884
Name:MAXWELL, BRANNIGAN (MHA, BSN, RN)
Entity type:Individual
Prefix:MS
First Name:BRANNIGAN
Middle Name:
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:MHA, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2736 DENALI PARK DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-1309
Mailing Address - Country:US
Mailing Address - Phone:469-765-6592
Mailing Address - Fax:
Practice Address - Street 1:2736 DENALI PARK DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-1309
Practice Address - Country:US
Practice Address - Phone:469-765-6592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX779844163W00000X, 163WC0200X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health