Provider Demographics
NPI:1912485780
Name:NEWELL, BRANDI FITZGERALD (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:FITZGERALD
Last Name:NEWELL
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 ROCKDALE RD
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-2413
Mailing Address - Country:US
Mailing Address - Phone:828-442-3094
Mailing Address - Fax:
Practice Address - Street 1:902 KIRKWOOD STREET NW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645
Practice Address - Country:US
Practice Address - Phone:828-754-0101
Practice Address - Fax:828-757-0402
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily