| NPI | 1356887053 |
|---|---|
| Former Name | BRANDIE SHANDELLE CAROLINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN221736) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2024-04-16 |