Provider Demographics
NPI:1871747576
Name:MORROW, BRANDY R
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:R
Last Name:MORROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 VILLAGE DR APT B
Mailing Address - Street 2:
Mailing Address - City:RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:11961-8307
Mailing Address - Country:US
Mailing Address - Phone:631-504-8989
Mailing Address - Fax:
Practice Address - Street 1:1201 VILLAGE DR APT B
Practice Address - Street 2:
Practice Address - City:RIDGE
Practice Address - State:NY
Practice Address - Zip Code:11961-8307
Practice Address - Country:US
Practice Address - Phone:631-504-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY294978164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse