# SUSAN BRANHAM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Susan Branham
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871117580
- **Authorized official:** SUSAN BRANHAM ANP-BC, PMHNP-BC (NURSE PRACTITIONER)
- **Authorized official phone:** (903) 575-7856

## Contact information

- **Practice address:** 107 W 20TH ST, MOUNT PLEASANT, TX 75455-2323
- **Practice address phone:** (903) 575-7856
- **Practice address fax:** (903) 572-3407
- **Mailing address:** 107 W 20TH ST, MOUNT PLEASANT, TX 75455-2323
- **Mailing address phone:** (903) 575-7856
- **Mailing address fax:** (903) 572-3407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/29/2020
- **Last updated:** 05/29/2020