Healthcare Provider Details
I. General information
NPI: 1538349287
Provider Name (Legal Business Name): BRANDI P FETNER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/10/2007
Last Update Date: 05/10/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US
IV. Provider business mailing address
2000 PEPPERELL PKWY
OPELIKA AL
36801-5452
US
V. Phone/Fax
- Phone: 334-528-1112
- Fax: 334-528-1547
- Phone: 334-528-1112
- Fax: 334-528-1547
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 146D00000X |
| Taxonomy | Personal Emergency Response Attendant |
| License Number | 1-083693 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 1-083693 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: