BRANDON BLAKE TELLER FNP-C
Individual Provider (NPI-1)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1285477018- Provider Type
- Individual Provider (NPI-1)
- Credentials
- FNP-C
- Status
- Active
Contact & Location
- Address
- 2100 US-61 N, VICKSBURG, MS, 391834500
- Phone
- (601) 415-6161
Specialties & Taxonomies
Registered Nurse, Critical Care Medicine
License: MS #918907
Nurse Practitioner, Family
Primary License: MS #F07250420