Organization
OLD TOWNE MEDICAL LLC
Active
Other names
Old Towne Medical
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN C BRAME CFNP (OWNER)
(901) 489-6595
Entity
Organization
Contact information
Practice address
9066 HIGHLAND ST, OLIVE BRANCH, MS 38654-2307
(662) 890-7717
(662) 874-6038
Mailing address
9066 HIGHLAND ST, OLIVE BRANCH, MS 38654-2307
(662) 890-7717
(662) 874-6038
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R644986
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03278318
—
MS
Enumeration date
10/30/2014
Last updated
07/30/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us