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Individual

MS. BRANDY NICHOLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1083 E RELHAM DR, LOXLEY, AL 36551-2406
(251) 964-4011
(251) 964-4012
Mailing address
PO BOX 2048, MOBILE, AL 36652-2048
(251) 432-4117
(251) 436-7765

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1133579
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1133579
STATE LICENSE
AL
Enumeration date
11/23/2022
Last updated
11/23/2022
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