Individual
BRANDI L VANDIVIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
28147845
IN
363LN0000X
Neonatal Nurse Practitioner
Primary
71002211A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000618963
ANTHEM PROVIDER NUMBER
IN
05
—
200908180
—
IN
Enumeration date
11/17/2006
Last updated
11/28/2025
Update your record
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