Provider Demographics
NPI:1770049231
Name:SANDERS, BRANDT JOSEPH (AGACNP)
Entity type:Individual
Prefix:
First Name:BRANDT
Middle Name:JOSEPH
Last Name:SANDERS
Suffix:
Gender:M
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-5939
Mailing Address - Country:US
Mailing Address - Phone:337-988-1585
Mailing Address - Fax:337-981-4694
Practice Address - Street 1:441 HEYMANN BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2611
Practice Address - Country:US
Practice Address - Phone:337-289-8429
Practice Address - Fax:337-289-8431
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP203902363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology