Provider Demographics
NPI:1700676780
Name:EHRENBERG, BRANDY NICHOLE
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:NICHOLE
Last Name:EHRENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:
Other - Last Name:FIRTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:704 E CLARK ST
Mailing Address - Street 2:
Mailing Address - City:WAUSA
Mailing Address - State:NE
Mailing Address - Zip Code:68786-1566
Mailing Address - Country:US
Mailing Address - Phone:580-216-5417
Mailing Address - Fax:
Practice Address - Street 1:704 E CLARK ST
Practice Address - Street 2:
Practice Address - City:WAUSA
Practice Address - State:NE
Practice Address - Zip Code:68786-1566
Practice Address - Country:US
Practice Address - Phone:580-216-5417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion