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General NPI Number Information
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NPI Number | 1730931569
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Entity Type | Individual
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Provider Name | BRANDI RAE CARNEY
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Gender | Female
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Dates
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Enumeration Date | 04/04/2024
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 834 W HIGHWAY 82 STE 102
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City | GAINESVILLE
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State | TX
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Zip | 76240-2533
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Country | US
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Telephone | 940-294-7302
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 193
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City | MUENSTER
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State | TX
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Zip | 76252-0193
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Country | US
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Telephone | 940-735-1100
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 1156767
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1156767
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License Number State | TX
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