Bustillos, Brandie N

Bustillos, Brandie N is an individual health care provider with primary practice located at 19305 Ruby Dr , Leesburg VA 20176-6508. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bustillos, Brandie N can be contacted via phone (571) 333-5918.

Contact Information

Primary practice address
19305 Ruby Dr Leesburg VA 20176-6508
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024167338 Virginia

Profile Details

NPI number 1548488927
LBN Legal business name Bustillos, Brandie N
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2007
Last updated Feb 23rd, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548488927 NPPES
Virginia MEDICAID 1548488927

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