BRANDON EMRY

FORT WAYNE, IN
NPI1164938007
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IN  71007787A)
Additional Taxonomies163W00000X Registered Nurse
(Licence: IN  28217961A)
Enumeration Date2017-12-14
Last Update Date2018-02-14
Business Address
BRANDON EMRY
11104 PARKVIEW CIRCLE DR STE 110
FORT WAYNE, IN 46845-1673
Phone number: 260-425-6780
Mailing Address
BRANDON EMRY
3702 NEW VISION DR BLDG B
FORT WAYNE, IN 46845-1703
Phone number: 260-266-6013