Provider Demographics
NPI:1295810216
Name:BILYEU, BRANDI N (OD)
Entity type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:N
Last Name:BILYEU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 OLYMPUS DR
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-5432
Mailing Address - Country:US
Mailing Address - Phone:307-672-2710
Mailing Address - Fax:
Practice Address - Street 1:1033 COFFEEN AV
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5375
Practice Address - Country:US
Practice Address - Phone:307-674-0444
Practice Address - Fax:307-673-0860
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY265T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0481576Medicaid
SD9201390Medicaid
WYU75807Medicare UPIN
MT0481576Medicaid