Healthcare Provider Details

I. General information

NPI: 1114340775
Provider Name (Legal Business Name): BRANDY STINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2014
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 E BROAD ST
COLUMBUS OH
43213-1502
US

IV. Provider business mailing address

6001 E BROAD ST
COLUMBUS OH
43213-1502
US

V. Phone/Fax

Practice location:
  • Phone: 614-234-9589
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberCOA.15222-NS
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberAPRN.CNS.15222
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: