Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | NEWS-1DCN7T | MS |
NPI | 1013491992 |
---|---|
Provider Name | Brandy Nicole Newsome Byrd |
First Address | Hazlehurst, MS 39083-2036 |
Second Address | Brandon, MS 39042-3038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2018 |
Last Update Date | 21/10/2019 |