Individual provider · NPI-1

Matthew Brandon, APRN

Nurse Practitioner, Family · Texarkana, AR

NPI number1194115691
StatusActive
Last updated in NPPESFeb 4, 2015

Details

NPI
1194115691
Entity type
Individual (NPI-1)
Name
Matthew Brandon
Credential
APRN
Sex
Male
Sole proprietor
Yes
Enumeration date
Feb 4, 2015
Last updated
Feb 4, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyA004194ARYes

Practice location

1414 Arkansas Blvd
Texarkana, AR 71854-1604

Phone 870-773-7246

Mailing address

1414 Arkansas Blvd
Texarkana, AR 71854-1604

Phone 870-773-7246

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