BRANDI CANADA (NPI# 1114542313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114542313 |
| Entity Type | Individual |
| Full Name | BRANDI CANADA |
| Practice Address |
6601 W 12th St Little Rock AR 72204-1513 |
| Mailing Address |
Po Box 251970 Little Rock AR 72225-1970 |
| Practice Telephone | 5016606821 |
| Practice Fax Number | 5016606830 |
| Mailing Telephone | 5016606821 |
| Mailing Fax Number | 5016606830 |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-06-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0807X |
Registered Nurse Specialization: Psych/Mental Health, Child & Adolescent |
225534 | AR | Nursing Service Providers |
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
225534 | AR | Nursing Service Providers |
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
225534 | AR | Nursing Service Providers |
| Street Address |
6601 W 12TH ST |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72204-1513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013020494 | Michael Ekdahl | Counselor | 6601 W 12th St, Little Rock, AR 72204-1513 | 2006-08-17 |
| 1033719786 | Alexis Stallings | Case Manager/Care Coordinator | 6601 W 12th St, Little Rock, AR 72204-1513 | 2020-10-30 |
| 1164022810 | James Tolbert | Case Manager/Care Coordinator | 6601 W 12th St, Little Rock, AR 72204-1513 | 2020-10-30 |
| 1558961490 | Jordan Pegues | Case Manager/Care Coordinator | 6601 W 12th St, Little Rock, AR 72204-1513 | 2020-10-29 |
| 1518567387 | Michael Simmons | Case Manager/Care Coordinator | 6601 W 12th St, Little Rock, AR 72204-1513 | 2020-10-29 |
| 1477151595 | Tianna Glover | Case Manager/Care Coordinator | 6601 W 12th St, Little Rock, AR 72204-1513 | 2020-10-12 |
| 1922606045 | Kadarius Knapper | Case Manager/Care Coordinator | 6601 W 12th St, Little Rock, AR 72204-1513 | 2020-10-12 |
| 1700491263 | Ferrell Bonner | Case Manager/Care Coordinator | 6601 W 12th St, Little Rock, AR 72204-1513 | 2020-09-11 |
| 1336754878 | Shantale Harris | Case Manager/Care Coordinator | 6601 W 12th St, Little Rock, AR 72204-1513 | 2020-09-11 |
| 1316552854 | Taylor Collins | Case Manager/Care Coordinator | 6601 W 12th St, Little Rock, AR 72204-1513 | 2020-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952966 | Shane Wilson | Non-emergency Medical Transport (VAN) | 1522 S Tyler St, Little Rock, AR 72204 | 2018-08-16 |
| 1659858348 | Poplar Grove Operations LLC | Skilled Nursing Facility | 7801 Kanis Road, Little Rock, AR 72204 | 2018-07-25 |
| 1275056004 | University of Arkansas for Medical Sciences | Orthopaedic Surgery | 108015 Colonel Glenn Rd, Little Rock, AR 72204 | 2017-07-24 |
| 1265954820 | Marilyn Marie Lynch | Registered Nurse | 7723 Colonel Glenn Road, Little Rock, AR 72204 | 2017-07-14 |
| 1962852954 | Arkansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1122 S. University Ave, Little Rock, AR 72204 | 2016-06-21 |
| 1841607751 | Charity Gillespie | Registered Nurse | 5210 Timberland Dr, Little Rock, AR 72204 | 2014-07-14 |
| 1043625221 | Interventional Surgery Institute of Little Rock, LLC | Clinic/Center | 9 Freeway Drive, Suite A, Little Rock, AR 72204 | 2014-06-25 |
| 1548696065 | Jamie Washington | Prosthetic/Orthotic Supplier | 4701 Westwood Ave, Little Rock, AR 72204 | 2013-09-16 |
| 1124468913 | Stephanie Rachelle Jez | Genetic Counselor, MS | 5800 West 10th Street, Freeway Medical Building, Suite 7-500, Little Rock, AR 72204 | 2013-06-26 |
| 1336492321 | Alton Charles Phillips Sr. | Counselor | 4400shuffield Drive, Little Rock, AR 72204 | 2012-10-16 |
| Find all providers in zip 72204 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033728266 | Cody Burkett | Registered Nurse | 11700 Kanis Rd Ste 2, Little Rock, AR 72211-3794 | 2020-07-23 |
| 1639701022 | Ryan Nikolai Leslie | Registered Nurse | 10025 W Markham St Ste 210, Little Rock, AR 72205-2178 | 2020-02-04 |
| 1851690994 | Roxanne Hunter | Registered Nurse | 1014 Autumn Rd, Suite 4, Little Rock, AR 72211-3704 | 2011-03-15 |
| 1093942344 | Donna K Arnold | Registered Nurse | 1014 Autumn Rd, Ste 3, Little Rock, AR 72211-3704 | 2009-06-14 |
| 1588678825 | Margaret Ann Grisham | Registered Nurse | 4300 W 7th St, 116p/nlr, Little Rock, AR 72205-5484 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992335707 | Candena Marie Fuller | Registered Nurse | 10 Canterbury Cir, Batesville, AR 72501-9185 | 2020-01-21 |
| 1538715180 | Ronald F. Henson | Registered Nurse | 8067 Highway 336 W, Clinton, AR 72031-8438 | 2019-08-09 |
| 1144459355 | Melanie Sterling & Assoc LLC | Registered Nurse | 2796 S 2nd St, Suite E, Cabot, AR 72023-7020 | 2009-07-09 |
| 1902933187 | Carol Ruth Vela | Registered Nurse | 2400 S 48th Street, Springdale, AR 72762 | 2007-02-27 |
| 1174617385 | Peggy Susan Morrow | Registered Nurse | 3805 Mccain Park Dr 116, North Little Rock, AR 72116-7813 | 2006-10-03 |
| 1477652089 | Tamra Sue Mcgehee | Registered Nurse | 311 Whittington Ave, Hot Springs, AR 71901-3407 | 2006-09-21 |
| 1003843277 | Jo Ann Clay | Registered Nurse | 680 Hogan Ln, Conway, AR 72034-8131 | 2006-06-26 |
| 1578050696 | Jon Paul Bradley | Registered Nurse | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2018-04-13 |
| 1356673909 | Erin Rae Morin | Registered Nurse | 2400 S 48th St, Springdale, AR 72762-6683 | 2010-02-08 |
| 1841445541 | Kimberly Young | Registered Nurse | 1311 Fort Street, Barling, AR 72923 | 2008-11-21 |
| Find all providers with the same taxonomy | ||||
| City | LITTLE ROCK |
| Zip Code | 72204 |
Please comment or provide details below to improve the information on BRANDI CANADA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.