Provider Demographics
NPI:1447880257
Name:NOKES, BRANDAN LEE (PA-C)
Entity type:Individual
Prefix:
First Name:BRANDAN
Middle Name:LEE
Last Name:NOKES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:22 S GREENE ST # N4WICU
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1544
Mailing Address - Country:US
Mailing Address - Phone:410-328-6749
Mailing Address - Fax:410-706-5103
Practice Address - Street 1:22 S GREENE ST # N4WICU
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-6749
Practice Address - Fax:410-328-7305
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC07881363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant