Mcgraw, Brandi Nichole Smith
Mcgraw, Brandi Nichole Smith is an individual health care provider with primary practice located at 816 Boardman Dr , Gallup NM 87301-4711. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Mcgraw, Brandi Nichole Smith can be contacted via phone (505) 339-2015.Contact Information
Primary practice address
816 Boardman Dr
Gallup NM 87301-4711
Phone: (505) 339-2015
Fax: (505) 492-0904
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 605 | New Mexico |
Profile Details
| NPI number | 1861631293 |
|---|---|
| LBN Legal business name | Mcgraw, Brandi Nichole Smith |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 9th, 2009 |
| Last updated | Jan 10th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861631293 | NPPES |
| Arizona | MEDICAID | 525331 | |
| Arizona | MEDICAID | 08778311 | |
| Arizona | Other | P00841382 |
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