Individual
BRENT FONDSHAY BROOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
6 DAVID PATTERSON RD, MOSELLE, MS 39459
(601) 596-3786
Mailing address
6 DAVID PATTERSON RD, MOSELLE, MS 39459-9439
(601) 596-3786
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
A034616
MS
343900000X
Non-emergency Medical Transport (VAN)
—
MS
3747A0650X
Attendant Care Provider
Primary
—
MS
3747A0650X
Attendant Care Provider
Primary
—
—
376K00000X
Nurse's Aide
A034616
MS
Other
Enumeration date
05/07/2010
Last updated
01/17/2026
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