Individual
MRS. STACY MARIE BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1038 MARKET ST, WHEELING, WV 26003-2912
(304) 232-7151
(304) 232-6128
Mailing address
1038 MARKET ST, WHEELING, WV 26003-2912
(304) 232-7151
(304) 232-6128
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
01010
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00112121
RAILROAD MEDICARE
WV
Enumeration date
08/01/2006
Last updated
03/07/2023
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