Healthcare Provider Details

I. General information

NPI: 1619856077
Provider Name (Legal Business Name): BRANDI PATRICIA WEGERLE NP-S, RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRANDI PATRICIA WEGERLE MSN, FNP-C

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 CORINTHIAN AVE
STRATFORD CT
06615-6501
US

IV. Provider business mailing address

1300 POST RD STE 3
FAIRFIELD CT
06824-6047
US

V. Phone/Fax

Practice location:
  • Phone: 760-899-2523
  • Fax:
Mailing address:
  • Phone: 475-302-6141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number206376
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number206376
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1218509
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-266230
License Number StateMT
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1218509
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95269675
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: