Provider Demographics
NPI:1780912105
Name:WEISEND, BRANDI JEAN (LPN)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:JEAN
Last Name:WEISEND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:BRANDI
Other - Middle Name:JEAN
Other - Last Name:DENVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:3200 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-9780
Mailing Address - Country:US
Mailing Address - Phone:740-260-0006
Mailing Address - Fax:
Practice Address - Street 1:3200 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-9780
Practice Address - Country:US
Practice Address - Phone:740-260-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 132196164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse