Brandy Nicole Mainord
Individual provider Active NPI Occupational Therapist · Stateline, NV
NPI 1629595103 · NPPES record last updated Aug 25, 2017
Key facts
- NPI
- 1629595103
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 17-0862 (NV)
- Practice address
- 315 Olypmic CT Unit B
Stateline, NV 89449-8944 - Phone
- (916) 759-7986
- NPI assigned
- Aug 25, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17-0862 | NV | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17-0862 | NV | Yes |
Addresses
Primary practice location
315 Olypmic CT Unit B
Stateline, NV 89449-8944
Mailing address
PO Box 4242
Stateline, NV 89449-4242
Phone (916) 759-7986
Other providers in Stateline, NV
- Cathey R Knight
- Lauren Michelle Lee
- Steven Dale Leman
- Hersel Lewis
- Paul Steven Llobet
- Paul Lance Marlowe
- Martin E. Salm, M.D., LTD
- Martin E. Salm, M.D., LTD.
- Maverick Medical, Inc.
- Larissa McCullough
All providers in Stateline, NV · Occupational Therapist in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.