Healthcare Provider Details

I. General information

NPI: 1689159212
Provider Name (Legal Business Name): BRANDI RENE HARBIN MSN, RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13596 HIGHWAY 231 431 N STE 4
HAZEL GREEN AL
35750-8618
US

IV. Provider business mailing address

PO BOX 2705
HUNTSVILLE AL
35804-2705
US

V. Phone/Fax

Practice location:
  • Phone: 256-428-4990
  • Fax: 256-428-4991
Mailing address:
  • Phone: 256-428-4900
  • Fax: 256-428-4912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-143271
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: