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General NPI Number Information
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NPI Number | 1255677027
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Entity Type | Individual
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Provider Name | BRANDI NICOLE SHARP APN
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Gender | Female
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Dates
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Enumeration Date | 12/21/2012
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 421 W WADE AVE
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-4622
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Country | US
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Telephone | 870-424-5010
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Fax | 870-424-2442
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Provider Business Mailing Address
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Address Line | 251 CONCORD LN
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-4235
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Country | US
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Telephone | 870-378-0107
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Fax | 870-424-2442
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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 | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | S002271
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License Number State | AR
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