Provider Demographics
NPI:1871356048
Name:DANG, BRANDON (FNP-BC)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:DANG
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:VINH
Other - Middle Name:QUANG
Other - Last Name:DANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2394 W WEATHERBY WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-8446
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 S HEARTHSTONE WAY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-5010
Practice Address - Country:US
Practice Address - Phone:602-932-0850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ239280363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily