Individual
BRANDI LOREAL WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7777 BLUEBONNET BLVD, BATON ROUGE, LA 70810-1632
(225) 766-9091
Mailing address
7777 BLUEBONNET BLVD, BATON ROUGE, LA 70810-1632
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07966
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07037554
—
MS
05
—
2387073
—
LA
Enumeration date
07/28/2014
Last updated
10/01/2018
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