Healthcare Provider Details

I. General information

NPI: 1639846736
Provider Name (Legal Business Name): BRANDY HEMERLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2591 BAGLYOS CIR STE C49
BETHLEHEM PA
18020-8058
US

IV. Provider business mailing address

2591 BAGLYOS CIR STE C49
BETHLEHEM PA
18020-8058
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-3025
  • Fax:
Mailing address:
  • Phone: 484-526-3025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN006600
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: