Individual
THOMAS JESSE BRANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
10101 RENNER BLVD, LENEXA, KS 66219-9752
(800) 873-8845
(913) 859-6887
Mailing address
25373 VAN DYKE AVE, CENTER LINE, MI 48015-1425
(586) 436-4469
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704243187
MI
Other
Enumeration date
03/24/2015
Last updated
09/06/2015
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