Provider Demographics
NPI:1245430651
Name:BRANNON, VERGIE M (GNP,DNP)
Entity type:Individual
Prefix:
First Name:VERGIE
Middle Name:M
Last Name:BRANNON
Suffix:
Gender:F
Credentials:GNP,DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 RIDGE POINT DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-5316
Mailing Address - Country:US
Mailing Address - Phone:214-878-3687
Mailing Address - Fax:
Practice Address - Street 1:230 RIDGE POINT DR
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-5316
Practice Address - Country:US
Practice Address - Phone:214-878-3687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX622930363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXNP0295Medicare PIN