Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | R864254 | MS |
NPI | 1013103613 |
---|---|
Provider Name | Emily Brumfield |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2007 |
Last Update Date | 30/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01454202 | (05) | MS |