Brandi Wallace is a Family in Fargo, North Dakota. Brandi Wallace practices all healthcare services and medical treatments related to Family. The NPI Number for Brandi Wallace is 1982739900. The last update date is 2019-10-25.
Brandi Wallace's current location address is 4622 40th Avenue South, Fargo, North Dakota. You can contact this provider via phone number 7013642909. The mailing address for Brandi Wallace is 4622 40th Avenue South, Fargo, North Dakota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brandi Wallace |
|---|---|
| Address | 4622 40th Avenue South, Fargo, North Dakota |
| Phone Number | 7013642909 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | FNP |
NPI Number Detail
| NPI Number | 1982739900 |
|---|---|
| Provider Enumeration Date | 2007-02-22 |
| Last Updated Date | 2019-10-25 |
Provider Mailing Address Detail
| Address | 4622 40th Avenue South |
|---|---|
| City | Fargo |
| State | North Dakota (ND) |
| Post Code | 581044394 |
| Phone Number | 7013642909 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | R30131 |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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What is the unique identifier code issued to Brandi Wallace by the Centers for Medicare & Medicaid Services?
The Brandi Wallace has been assigned the NPI (National Provider Identifier) 1982739900. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Brandi Wallace is physically located?
The Brandi Wallace is situated at the following address: 4622 40Th Avenue South, Fargo, ND 581044394.
What is the Brandi Wallace's specialty and taxonomy code?
The Brandi Wallace's specialty is Family, and the corresponding taxonomy code is 363Lf0000X.
When was the Brandi Wallace's 1982739900 issued?
The Brandi Wallace's 1982739900 was issued on 2007-02-22.
As of what date were the Brandi Wallace's details last updated?
The information pertaining to the Brandi Wallace, including its address, specialty, and other details, was most recently updated on 2019-10-25.
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