Healthcare Provider Details

I. General information

NPI: 1710578315
Provider Name (Legal Business Name): BRANDY ZOLLARS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1379 E END RD STE 3
HOMER AK
99603-7250
US

IV. Provider business mailing address

PO BOX 401
HOMER AK
99603-0401
US

V. Phone/Fax

Practice location:
  • Phone: 907-299-6410
  • Fax: 833-411-1331
Mailing address:
  • Phone: 907-299-6410
  • Fax: 833-411-1331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number270929
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-191599
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10789-33
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number203115
License Number StateAK
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61245432
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0998847-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: