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General NPI Number Information
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NPI Number | 1760705206
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Entity Type | Individual
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Provider Name | ALEXIS GUY BRANDON PA
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Gender | Female
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Dates
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Enumeration Date | 03/11/2010
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 10345 PROFESSIONAL CIR
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City | RENO
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State | NV
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Zip | 89521-5862
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Country | US
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Telephone | 800-929-0926
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Fax | 800-238-6575
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Provider Business Mailing Address
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Address Line | 10345 PROFESSIONAL CIR
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City | RENO
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State | NV
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Zip | 89521-5862
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Country | US
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Telephone | 800-929-0926
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Fax | 800-238-6575
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA20867
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License Number State | CA
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