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General NPI Number Information
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NPI Number | 1265154884
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Entity Type | Individual
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Provider Name | WHITNEY BRANNON NP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 222 GORDON ST
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City | BREMEN
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State | GA
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Zip | 30110-1519
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Country | US
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Telephone | 770-537-1236
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Fax |
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Provider Business Mailing Address
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Address Line | 1079 MORMON CHURCH RD
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City | BUCHANAN
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State | GA
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Zip | 30113-3624
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Country | US
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Telephone |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 363LF0000X
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN256523
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License Number State | GA
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