Provider Demographics
NPI:1134743404
Name:LINGENHOEL, BRANDI L (APRN)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:L
Last Name:LINGENHOEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 CADBURY ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-2894
Mailing Address - Country:US
Mailing Address - Phone:234-214-3388
Mailing Address - Fax:
Practice Address - Street 1:1712 CADBURY ST NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-2894
Practice Address - Country:US
Practice Address - Phone:234-214-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH399133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily