Tacia, Brandy Marie
Tacia, Brandy Marie is an individual health care provider with primary practice located at 750 N Syringa St Ste 203A , Post Falls ID 83854-5275. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Facial Plastic Surgery, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is her primary health care specialty. Tacia, Brandy Marie can be contacted via phone (208) 262-2717.Contact Information
Primary practice address
750 N Syringa St Ste 203A
Post Falls ID 83854-5275
Phone: (208) 262-2717
Fax: (208) 262-2719
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Facial Plastic Surgery | 207YS0123X | O-0622 | Idaho |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | O-0622 | Idaho |
Profile Details
| NPI number | 1467667550 |
|---|---|
| LBN Legal business name | Tacia, Brandy Marie |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 11th, 2007 |
| Last updated | May 2nd, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467667550 | NPPES |
| Idaho | MEDICAID | 1467667550 | |
| Idaho | MEDICAID | 2013695 |
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