Brandeis Brockman, CRNP
Nurse Practitioner, Family in Bala Cynwyd, PA. Individual provider (NPI-1).
NPI number1114289402
StatusActive
Last updated in NPPESMay 13, 2026
Details
- NPI
- 1114289402
- Entity type
- Individual (NPI-1)
- Name
- Brandeis Brockman
- Credential
- CRNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 12, 2012
- Certification date
- May 13, 2026
- Last updated
- May 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | SP012117 | PA | Yes |
Practice location
15 Presidential BlvdBala Cynwyd, PA 19004-1006
Phone 610-668-8300
Mailing address
2630 W Girard Ave Unit 9137Philadelphia, PA 19130-1483
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