Basic Information
| Provider Information | |||||||||
| NPI: | 1043617855 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KOHN | ||||||||
| FirstName: | BRANDI | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7987 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366700987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516330573 | ||||||||
| FaxNumber: | 2516337367 | ||||||||
| Practice Location | |||||||||
| Address1: | 5955 AIRPORT BLVD | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516330573 | ||||||||
| FaxNumber: | 2516337367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2014 | ||||||||
| LastUpdateDate: | 06/28/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 1-122336 | AL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 1122336 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 171394 | 05 | AL | MEDICAID | Z94090 | 01 | AL | VIVA HEALTH | OTHER | 511-58768 | 01 | AL | BCBS | OTHER | 512-06694 | 01 | AL | BCBS | OTHER | 221585 | 05 | AL | MEDICAID | 5329049 | 01 | AL | UHC | OTHER | 5116736 | 01 | AL | AETNA | OTHER | 213489 | 05 | AL | MEDICAID | 512-06695 | 01 | AL | BCBS | OTHER | 222626 | 05 | AL | MEDICAID | 511-95733 | 01 | AL | BCBS | OTHER | 03988710 | 01 | MS | MS MEDICAID | OTHER | 102I503889 | 01 | AL | MEDICARE | OTHER | 214121 | 05 | AL | MEDICAID | P01472078 | 01 | AL | RR MEDICARE | OTHER |