Provider Demographics
NPI:1770804882
Name:BRAND, JENNIFER L (ARNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:BRAND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:SABRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1613 N. HARRISON PKWY
Mailing Address - Street 2:STE. 200
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2896
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:10101 W. FOREST HILL BLVD.
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6103
Practice Address - Country:US
Practice Address - Phone:954-838-2371
Practice Address - Fax:954-851-1746
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCRNA9226884367500000X
FLARNP9226884367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered