Individual
BRANDI C MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4293 KINSEY DR, TYLER, TX 75703-1004
(903) 592-5670
(888) 960-2797
Mailing address
17604 E LAKE ESTATES DR, ARP, TX 75750-9688
(903) 920-9831
(903) 747-3013
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F0811448
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2930422
—
TX
01
—
738639
TEXAS BOARD OF NURSING NP LICENSE
—
01
—
AP120947
FNP LICENSE
TX
01
—
F0811448
AANP
TX
Enumeration date
09/20/2011
Last updated
06/23/2021
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