Provider Demographics
NPI:1740627603
Name:WRIGHT, BRANDI C (FNP-C)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:C
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:C
Other - Last Name:HUBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2645 NALL ST
Mailing Address - Street 2:
Mailing Address - City:PORT NECHES
Mailing Address - State:TX
Mailing Address - Zip Code:77651-4707
Mailing Address - Country:US
Mailing Address - Phone:409-210-3336
Mailing Address - Fax:409-527-3969
Practice Address - Street 1:2645 NALL ST
Practice Address - Street 2:
Practice Address - City:PORT NECHES
Practice Address - State:TX
Practice Address - Zip Code:77651-4707
Practice Address - Country:US
Practice Address - Phone:409-210-3336
Practice Address - Fax:409-527-3969
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693188363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1740627603OtherNPI