Individual
MARY ALICE BRANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CLNC,CIC
Contact information
Practice address
20620 RIVER RD, SUTHERLAND, VA 23885-9539
(804) 691-3193
(804) 691-3193
Mailing address
20620 RIVER RD, SUTHERLAND, VA 23885-9539
(804) 691-3193
(804) 691-3193
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001180795
VA
163WI0600X
Infection Control Registered Nurse
123-4054-731184
VA
Other
Enumeration date
01/23/2026
Last updated
01/23/2026
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