MEDICARE: BRANDI KAMMERER PLLC

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	R89215	OK

General Provider Information

NPI Number	:	1679879472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANDI KAMMERER PLLC

Provider Business Mailing Address
First Line	:	1601 SW 89TH ST STE F200
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-6358
Country	:	US
Telephone Number	:	405-688-9801
Fax Number	:	405-688-9800

Provider Business Practice Location Address
First Line	:	1601 SW 89TH ST STE F200
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-6358
Country	:	US
Telephone Number	:	405-688-9801
Fax Number	:	405-688-9800

Authorized Official
Title or Position	:	OWNER
Name	:	BRANDI KAMMERER
Credential	:	ARNP
Telephone Number	:	405-688-9801

Provider Enumeration Date	:	01/27/2011
Last Update Date	:	02/23/2011

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