Provider Demographics
NPI:1023765898
Name:SARGENT, BRANDY
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:SARGENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 LONGABAUGH WAY
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-9699
Mailing Address - Country:US
Mailing Address - Phone:307-757-5868
Mailing Address - Fax:866-544-1881
Practice Address - Street 1:6500 LONGABAUGH WAY
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-9699
Practice Address - Country:US
Practice Address - Phone:307-757-5868
Practice Address - Fax:866-544-1881
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator