Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | COA.14736-NP | OH |
N | 363LP2300X | Nurse Practitioner - Primary Care | APRN75688 | WV |
NPI | 1033558549 |
---|---|
Provider Name | Brandon N. Dewees |
First Address | Point Pleasant, WV 25550 |
Second Address | Mason, WV 25260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2013 |
Last Update Date | 19/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0088158 | (05) | OH |
3810026234 | (05) | WV |