LAURA L BRANDENBURG (NPI# 1114460995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114460995 |
| Entity Type | Individual |
| Full Name | LAURA L BRANDENBURG |
| Other Name | LAURA L HUDDLESTON |
| Credential | FNP |
| Practice Address |
4 Memorial Dr Ste 230b Alton IL 62002-6751 |
| Mailing Address |
670 Mason Ridge Center Dr Ste 300 Saint Louis MO 63141-8573 |
| Practice Telephone | 6184637777 |
| Practice Fax Number | 6184637767 |
| Mailing Telephone | 6184637777 |
| Mailing Fax Number | 6184637767 |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2016-11-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209003963 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4 MEMORIAL DR STE 230B |
| City | ALTON |
| State | IL |
| Zip Code | 62002-6751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669460655 | Rafael De La Cruz | Internal Medicine | 4 Memorial Dr, 1st Floor, Alton, IL 62002-6751 | 2005-10-12 |
| 1417372772 | Mary Stuart | Physician Assistant | 4 Memorial Dr, Ste 130b, Alton, IL 62002-6751 | 2014-02-24 |
| 1750716726 | Lyndsi K Sievers | Physician Assistant | 4 Memorial Dr, Ste 130b, Alton, IL 62002-6751 | 2013-09-10 |
| 1386989549 | Casey Newgent | Physician Assistant | 4 Memorial Dr, Ste 130b, Alton, IL 62002-6751 | 2012-11-29 |
| 1457624108 | Brianna Phillips | Social Worker | 4 Memorial Dr, Alton, IL 62002-6705 | 2012-02-10 |
| 1962713073 | Dawn Nicole Talbert | Family Medicine | 4 Memorial Dr, Ste 230, Alton, IL 62002-6751 | 2010-06-24 |
| 1295998748 | Olusegun Adebayo Coker | Family Medicine | 4 Memorial Dr, Ste 230, Alton, IL 62002-6751 | 2008-07-04 |
| 1841461134 | Aaron Patrick Omotola | Orthopaedic Surgery | 4 Memorial Dr, Ste 130b, Alton, IL 62002-6751 | 2008-03-14 |
| 1104026707 | Christopher Ryan Aldridge | Surgery | 4 Memorial Dr, Ste 230, Alton, IL 62002-6751 | 2007-07-20 |
| 1851598429 | John W Stirton | Orthopaedic Surgery | 4 Memorial Dr, Ste 130b, Alton, IL 62002-6751 | 2007-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| Find all providers in zip 62002 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841842341 | Yolanda A Suber | Nurse Practitioner | 2615 Edwards St Ste 171, Alton, IL 62002-3915 | 2019-07-15 |
| 1275027344 | Amanda Willane Michaels | Nurse Practitioner | 2 Memorial Dr Ste 220, Alton, IL 62002-6723 | 2018-06-21 |
| 1558864629 | Felecia V Ernst | Nurse Practitioner | 2 Memorial Dr Ste 122, Alton, IL 62002-6723 | 2018-03-14 |
| 1992243265 | Elizabeth O'brien | Nurse Practitioner | 2 Saint Anthonys Way Ste 101, Alton, IL 62002-4580 | 2017-02-07 |
| 1588118855 | Anjanette Stendeback | Nurse Practitioner | 1015 Langdon St, Alton, IL 62002-3655 | 2016-08-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| 1669544201 | Gene Elizabeth Harkless | Nurse Practitioner | 720 Stockbridge Corner Road, Alton, NH 03809-0111 | 2006-11-15 |
| 1225121619 | Cheryl L Bray | Nurse Practitioner | 2811 Homer M Adams Pkwy, Alton, IL 62002-4856 | 2006-09-30 |
| 1992724090 | Hector Rodriguez | Nurse Practitioner | 3509 E Main Ave, Suite 101, Alton, TX 78573-1561 | 2006-07-19 |
| 1588644181 | Judith Wood Cole | Nurse Practitioner | Alton Family Medicine, 82 Main Street, Alton, NH 03809 | 2006-01-19 |
| Find all providers in ALTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.