BRANDY BLUE NPI 1225650542

NPI Information

NPI: 1225650542
Provider Name: BRANDY BLUE
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: PREMIER MEDICAL GROUP PSC

PECOS Registration: Yes

Address:
1030A BURLEW BLVD
OWENSBORO, KY
ZIP 42303
Phone: (270) 926-2273
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Brandy Blue is a family nurse practitioner in Owensboro, KY with 4 years of experience. Brandy Blue NPI is 1225650542. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1030A BURLEW BLVD
OWENSBORO, KY
ZIP 42303-735
Phone: (270) 926-2273
Fax: (270) 684-3212

The NPI 1225650542 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/8/2020 and was last updated on 7/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WG0600X	Registered Nurse	Gerontology	1132083	KENTUCKY	No
2	363LF0000X	Nurse Practitioner	Family	3014919	KENTUCKY	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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