Provider Demographics
NPI:1295525152
Name:MENENDEZ, BRANDY ELLI (FNP-C)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:ELLI
Last Name:MENENDEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:ELLI
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1509 DALY RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-3316
Mailing Address - Country:US
Mailing Address - Phone:630-877-8591
Mailing Address - Fax:
Practice Address - Street 1:1509 DALY RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-3316
Practice Address - Country:US
Practice Address - Phone:630-877-8591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.032336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily