MEDICARE: BRANDI WARE NP

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
1	363LF0000X	Family Nurse Practitioner	1-131255	AL

General Provider Information

NPI Number	:	1467808881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI WARE NP

Provider Business Mailing Address
First Line	:	309 TAYLOR ST
Second Line	:
City	:	SCOTTSBORO
State	:	AL
Zip	:	35768-2421
Country	:	US
Telephone Number	:	256-259-5313
Fax Number	:	256-259-4923

Provider Business Practice Location Address
First Line	:	60 MAIN ST N
Second Line	:
City	:	SECTION
State	:	AL
Zip	:	35771-7168
Country	:	US
Telephone Number	:	256-228-3471
Fax Number	:	256-228-7289

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2016
Last Update Date	:	07/15/2021

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Directions to “ BRANDI WARE NP” Practice Location

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