Provider Demographics
NPI:1750196622
Name:THOMAS, BRANDY C (RN)
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:C
Last Name:THOMAS
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 1:40700 E 331ST ST
Mailing Address - Street 2:
Mailing Address - City:CREIGHTON
Mailing Address - State:MO
Mailing Address - Zip Code:64739-8648
Mailing Address - Country:US
Mailing Address - Phone:913-544-6488
Mailing Address - Fax:
Practice Address - Street 1:40700 E 331ST ST
Practice Address - Street 2:
Practice Address - City:CREIGHTON
Practice Address - State:MO
Practice Address - Zip Code:64739-8648
Practice Address - Country:US
Practice Address - Phone:913-544-6488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005032358163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management