Healthcare Provider Details

I. General information

NPI: 1396761771
Provider Name (Legal Business Name): BRANDY PEARROW APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OPTUM CIR
EDEN PRAIRIE MN
55344-2956
US

IV. Provider business mailing address

1 OPTUM CIR
EDEN PRAIRIE MN
55344-2956
US

V. Phone/Fax

Practice location:
  • Phone: 800-561-0861
  • Fax:
Mailing address:
  • Phone: 800-561-0861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1417
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: