Provider Demographics
NPI:1205313632
Name:POIRIER, BRANDY ANN (RN)
Entity type:Individual
Prefix:MISS
First Name:BRANDY
Middle Name:ANN
Last Name:POIRIER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 BLOEDEL AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-2238
Mailing Address - Country:US
Mailing Address - Phone:715-370-8654
Mailing Address - Fax:
Practice Address - Street 1:1816 BLOEDEL AVE APT 4
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-2238
Practice Address - Country:US
Practice Address - Phone:715-370-8654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-28
Last Update Date:2018-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI228005163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse