Individual
MRS. BRANDIE NICOLE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
961 S GLOSTER ST, TUPELO, MS 38801-6343
(662) 377-4550
Mailing address
961 S GLOSTER ST, TUPELO, MS 38801-6343
(662) 377-4550
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905824
MS
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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