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General NPI Number Information
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NPI Number | 1134944978
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Entity Type | Individual
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Provider Name | BRANDY MIKKALINA VADEN PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | DR. HITZELBERGER STRASSE
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City | LANDSTUHL
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State | RHINELAND-PFALZ
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Zip | 66849
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Country | DE
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Telephone | 314-590-6343
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 402 BOX 1528
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City | APO
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State | AE
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Zip | 09180-1016
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Country | US
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Telephone | 336-416-2202
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61618786
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License Number State | WA
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