Healthcare Provider Details

I. General information

NPI: 1023434297
Provider Name (Legal Business Name): BRANDLYNN NELSON M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 CONNECTICUT AVE NW APT 217
WASHINGTON DC
20008-5701
US

IV. Provider business mailing address

164 NW MADISON ST
LAKE CITY FL
32055-3904
US

V. Phone/Fax

Practice location:
  • Phone: 703-568-1707
  • Fax:
Mailing address:
  • Phone: 386-758-1811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: