Wallace, Brandi

Wallace, Brandi is an sole proprietor health care provider with primary practice located at 4622 40Th Avenue South Suite A, Fargo ND 58104-4394. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Wallace, Brandi can be contacted via phone (701) 364-2909.

Contact Information

Primary practice address
4622 40Th Avenue South Suite A Fargo ND 58104-4394
Phone: (701) 364-2909
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X R144003-8 Minnesota
Nursing Service Providers / Registered Nurse 163W00000X 149297-030 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R30131 North Dakota

Profile Details

NPI number 1982739900
LBN Legal business name Wallace, Brandi
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2007
Last updated Oct 25th, 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.

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