Individual
MICHAELYN H. BRABHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
7373 PERKINS RD, ATTN: CAMILLE/ ADMINISTRATION, BATON ROUGE, LA 70808-4326
(225) 769-4044
Mailing address
7373 PERKINS RD, ATTN: CAMILLE/ ADMINISTRATION, BATON ROUGE, LA 70808-4326
(225) 769-4044
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP06909
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP06909
STATE LICENSE
LA
Enumeration date
06/22/2012
Last updated
10/25/2012
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