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NPI Code Detail

MEDICARE: BRANDON NOELL RESPRESS PHD, RN, PMHNP-BC

MEDICARE: BRANDON NOELL RESPRESS PHD, RN, PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse290225OH
2163W00000XRegistered Nurse867185TX
3363LP0808XPsychiatric/Mental Health Nurse Practitioner46903WY
4363LP0808XPsychiatric/Mental Health Nurse Practitioner0027883OH
5363LP0808XPsychiatric/Mental Health Nurse PractitionerAP145794TX

General Provider Information

NPI Number : 1053958850
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON NOELL RESPRESS PHD, RN, PMHNP-BC
Provider Business Mailing Address
First Line : 10300 N CENTRAL EXPY STE 280
Second Line :
City : DALLAS
State : TX
Zip : 75231-8666
Country : US
Telephone Number : 469-834-7124
Fax Number : 844-905-1370
Provider Business Practice Location Address
First Line : 1309 COFFEEN AVE STE 1200
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-5777
Country : US
Telephone Number : 214-253-8756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2019
Last Update Date : 12/09/2022

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