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General NPI Number Information
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NPI Number | 1205030335
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Entity Type | Individual
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Provider Name | SANDY MICHELE BRANSON APRN
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Gender | Female
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 11/30/2025
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Provider Practice Location Address
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Address Line | 1970 E JOYCE BLVD STE 2
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5135
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Country | US
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Telephone | 479-265-5198
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Fax | 479-339-3077
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Provider Business Mailing Address
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Address Line | PO BOX 12
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City | WINSLOW
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State | AR
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Zip | 72959-0012
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Country | US
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Telephone | 479-601-6201
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Fax | 479-339-3077
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A02935
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R66717
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License Number State | AR
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