Provider Demographics
NPI:1184998742
Name:FARMER, BRANDY LEIGH (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:LEIGH
Last Name:FARMER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S HERLONG AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8350
Mailing Address - Country:US
Mailing Address - Phone:803-329-3899
Mailing Address - Fax:803-327-3438
Practice Address - Street 1:410 S HERLONG AVE STE 106
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8350
Practice Address - Country:US
Practice Address - Phone:803-329-3899
Practice Address - Fax:803-327-3438
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17739363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2038Medicaid
SCNP2038Medicaid