Provider Demographics
NPI:1780256297
Name:BARTOS, BRANDIE DARLENE (FNP)
Entity type:Individual
Prefix:
First Name:BRANDIE
Middle Name:DARLENE
Last Name:BARTOS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12820 FOREST CREEK CT
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-5526
Mailing Address - Country:US
Mailing Address - Phone:443-536-5712
Mailing Address - Fax:833-906-2570
Practice Address - Street 1:6220 GEORGETOWN BLVD STE C
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6417
Practice Address - Country:US
Practice Address - Phone:144-353-6571
Practice Address - Fax:833-906-2570
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR209741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1235802489OtherBB'S ALLCARE GROUP NPI
DC1124484779Medicaid