Individual
BRANDEE JO FLAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601
(574) 234-5123
(574) 282-2813
Mailing address
100 E WAYNE ST STE 510, SOUTH BEND, IN 46601-2394
(574) 334-5390
(574) 334-5368
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003179A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000646392
ANTHEM
IN
05
—
200973990
—
IN
Enumeration date
10/08/2009
Last updated
08/23/2018
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