Healthcare Provider Details

I. General information

NPI: 1679929111
Provider Name (Legal Business Name): BRANDI ALEXANDRIA MARTINEZ CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRANDI ALEXANDRIA DEMMONS CNP

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 WILLIAM HOWARD TAFT RD
CINCINNATI OH
45219-2103
US

IV. Provider business mailing address

2020 ANDERSON FERRY RD STE A
CINCINNATI OH
45238-3371
US

V. Phone/Fax

Practice location:
  • Phone: 513-616-8774
  • Fax: 513-861-0105
Mailing address:
  • Phone: 513-347-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.18973-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN356643
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: