Flagg, Brandee Jo

Flagg, Brandee Jo is an individual health care provider with primary practice located at 615 N Michigan St , South Bend IN 46601. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Flagg, Brandee Jo can be contacted via phone (574) 234-5123.

Contact Information

Primary practice address
615 N Michigan St South Bend IN 46601
Phone: (574) 234-5123
Fax: (574) 282-2813
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71003179A Indiana

Profile Details

NPI number 1649505637
LBN Legal business name Flagg, Brandee Jo
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 8th, 2009
Last updated Aug 23rd, 2018 - about 6 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 1649505637 NPPES
Indiana MEDICAID 200973990
Indiana Other 000000646392

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