MEDICARE: BRANDI THOMAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1-136761	AL
2	363L00000X	Nurse Practitioner	1-136761	AL

General Provider Information

NPI Number	:	1538031083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI THOMAS

Provider Business Mailing Address
First Line	:	1403 OLD WATER WORKS RD SW
Second Line	:
City	:	FORT PAYNE
State	:	AL
Zip	:	35968-3353
Country	:	US
Telephone Number	:	256-646-7246
Fax Number	:	256-304-5333

Provider Business Practice Location Address
First Line	:	1403 OLD WATER WORKS RD SW
Second Line	:
City	:	FORT PAYNE
State	:	AL
Zip	:	35968-3353
Country	:	US
Telephone Number	:	256-646-7246
Fax Number	:	256-304-5333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	09/23/2025

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Directions to “ BRANDI THOMAS ” Practice Location

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