Provider Demographics
NPI:1669048484
Name:MORTON, BRANDY MARSHAY (NP)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:MARSHAY
Last Name:MORTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4299
Mailing Address - Country:US
Mailing Address - Phone:864-227-7250
Mailing Address - Fax:
Practice Address - Street 1:1110 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4299
Practice Address - Country:US
Practice Address - Phone:864-227-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC238279363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology