Individual
MISS BRANDI ELIZABETH BORDELON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
192 BASTILLE LN STE 200, RUSTON, LA 71270-7150
(318) 232-1500
Mailing address
5 LEE ANN ST, RAYVILLE, LA 71269-5529
(318) 403-1590
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
206789
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01071992
DOC/ICE
—
Enumeration date
07/27/2019
Last updated
05/11/2026
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