Individual provider · Type 1 NPI

Maranda Brooke Etheredge, AGACNP-BC

Nurse Practitioner · Dallas, TX

NPI number 1871470682 Active

Practice location

2710 Swiss Ave
Dallas, TX 75204-5900

Call (214) 821-1599 Map

Mailing address

3610 Gillespie St Apt 6
Dallas, TX 75219-4979

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X1212740 (TX)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1871470682

Maranda Brooke Etheredge, AGACNP-BC's National Provider Identifier is 1871470682, issued on Aug 21, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Dallas, TX. The record was last updated on Sep 11, 2025.