Provider Demographics
NPI:1730931569
Name:CARNEY, BRANDI RAE
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:RAE
Last Name:CARNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:MUENSTER
Mailing Address - State:TX
Mailing Address - Zip Code:76252-0193
Mailing Address - Country:US
Mailing Address - Phone:940-735-1100
Mailing Address - Fax:
Practice Address - Street 1:834 W HIGHWAY 82 STE 102
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-2533
Practice Address - Country:US
Practice Address - Phone:940-294-7302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1156767207N00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207N00000XAllopathic & Osteopathic PhysiciansDermatology