Provider Demographics
NPI:1265715825
Name:NEWMAN, BRANDI LYNNE (LVN)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:LYNNE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 OLYMPIC WAY APT P
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-7923
Mailing Address - Country:US
Mailing Address - Phone:760-453-8077
Mailing Address - Fax:
Practice Address - Street 1:910 E OHIO AVE STE 104
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3439
Practice Address - Country:US
Practice Address - Phone:760-745-7786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH145722164W00000X
CAVN264691164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse