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NPI Code Detail

MEDICARE: BRANDI LANICE ALWINE PA

MEDICARE: BRANDI LANICE ALWINE PA
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1770718173
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDI LANICE ALWINE PA
Provider Business Mailing Address
First Line : 416 E MAUMEE ST
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2015
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 306 E MAUMEE ST STE 303
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2044
Country : US
Telephone Number : 260-667-5148
Fax Number : 260-667-5689
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2009
Last Update Date : 07/17/2025

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Directions to “ BRANDI LANICE ALWINE PA” Practice Location

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