Provider Demographics
NPI:1912298209
Name:ALEXANDER, BRANDY DANIELLE (CNP)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:DANIELLE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 N CENTRAL AVE STE 1175
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-0002
Mailing Address - Country:US
Mailing Address - Phone:888-698-6727
Mailing Address - Fax:602-564-6246
Practice Address - Street 1:1142 W GUADALUPE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-7602
Practice Address - Country:US
Practice Address - Phone:602-755-0800
Practice Address - Fax:602-560-2721
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH368204163W00000X
OHCNP023619363LF0000X
AZ218787363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse