Provider Demographics
NPI:1669809232
Name:MACKIN, BRANDI J (RN)
Entity type:Individual
Prefix:MR
First Name:BRANDI
Middle Name:J
Last Name:MACKIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2284 BURNS HILL RD
Mailing Address - Street 2:
Mailing Address - City:LOBELVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37097-4623
Mailing Address - Country:US
Mailing Address - Phone:931-593-2150
Mailing Address - Fax:
Practice Address - Street 1:31 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TN
Practice Address - Zip Code:37096-3326
Practice Address - Country:US
Practice Address - Phone:931-583-2138
Practice Address - Fax:931-589-5414
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000156479163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health