Individual
BRANDI RAE SENIOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16 N LA PLATA CT, LA PLATA, MD 20646-4283
(301) 392-3330
(301) 392-3950
Mailing address
7250 PARKWAY DR, STE 500, HANOVER, MD 21076-1343
(443) 949-0814
(443) 949-0814
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0004239
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01658288
RR MEDICARE
MD
Enumeration date
04/25/2008
Last updated
08/08/2017
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