Provider Demographics
NPI:1336830751
Name:BRANDT, MICHELLE LIN (APRN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LIN
Last Name:BRANDT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332
Mailing Address - Country:US
Mailing Address - Phone:361-998-9970
Mailing Address - Fax:
Practice Address - Street 1:3308 E MAIN ST
Practice Address - Street 2:
Practice Address - City:AICE
Practice Address - State:TX
Practice Address - Zip Code:78332
Practice Address - Country:US
Practice Address - Phone:361-998-9970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1100499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily