Healthcare Provider Details

I. General information

NPI: 1053070730
Provider Name (Legal Business Name): BRANDI HARLOW FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2021
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 1ST ST STE A
SAN FRANCISCO CA
94105-2661
US

IV. Provider business mailing address

29027 RED LOOP DR
NEW CANEY TX
77357-6135
US

V. Phone/Fax

Practice location:
  • Phone: 888-803-3370
  • Fax:
Mailing address:
  • Phone: 352-586-4605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1000599
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1000599
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: