Provider Demographics
NPI:1679170047
Name:ZEY, BRANDI (APRN-CNP)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:ZEY
Suffix:
Gender:
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:ZEY-THACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:606 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65233-1523
Mailing Address - Country:US
Mailing Address - Phone:660-882-3955
Mailing Address - Fax:
Practice Address - Street 1:606 E SPRING ST
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:MO
Practice Address - Zip Code:65233-1523
Practice Address - Country:US
Practice Address - Phone:660-882-3955
Practice Address - Fax:660-882-3972
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003031307163W00000X
MO2020033722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse