Provider Demographics
NPI:1013501527
Name:COWARD, BRANDY (NP)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:COWARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17100 PIONEER BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-2761
Mailing Address - Country:US
Mailing Address - Phone:562-531-4100
Mailing Address - Fax:
Practice Address - Street 1:17100 PIONEER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-2761
Practice Address - Country:US
Practice Address - Phone:562-531-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV822001363LF0000X
AZ227049363LF0000X
CA95015004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily