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NPI Code Detail

MEDICARE: BRANDY D BARE RN

MEDICARE: BRANDY D BARE RN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner899974NV
2163W00000XRegistered NurseRN39853NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN39853OTHERNVNURSING LICENSE
2899974OTHERNVNEVADA STATE BOARD OF NURSING NP LICENSE NUMBER

General Provider Information

NPI Number : 1669075057
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY D BARE RN
Provider Business Mailing Address
First Line : 3573 SNOWY RIV
Second Line :
City : ELKO
State : NV
Zip : 89801-5360
Country : US
Telephone Number : 775-374-0957
Fax Number :
Provider Business Practice Location Address
First Line : 515 SHOSHONE CIR
Second Line :
City : ELKO
State : NV
Zip : 89801-5072
Country : US
Telephone Number : 775-738-2252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2020
Last Update Date : 05/06/2026

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