Healthcare Provider Details

I. General information

NPI: 1215104518
Provider Name (Legal Business Name): BRANDY KAY FLEISCHER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 02/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 NATIONWIDE DRIVE SUITE A
LYNCHBURG VA
24502
US

IV. Provider business mailing address

121 NATIONWIDE DRIVE SUITE A
LYNCHBURG VA
24502
US

V. Phone/Fax

Practice location:
  • Phone: 434-384-1862
  • Fax: 434-384-7704
Mailing address:
  • Phone: 434-384-1862
  • Fax: 434-384-7704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number0017139137
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0024167793
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number0001153656
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: