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Individual

VIRGINIA LYNN BRANTLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
2400 S.R. 415, SANFORD, FL 32771-6012
(407) 322-8645
Mailing address
2400 STATE ROAD 415, SANFORD, FL 32771-6012
(407) 322-8645

Taxonomy

Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
1183862
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
192242
HEALTHEASE
FL
05
305641400
FL
Enumeration date
05/31/2005
Last updated
01/19/2012
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