Individual
BRANDI BORNE DEGRUISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1022 BELANGER ST, HOUMA, LA 70360-4412
(985) 223-3132
(985) 346-0836
Mailing address
PO BOX 1094, HOUMA, LA 70361-1094
(985) 209-1444
(985) 346-0836
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN102495-AP05149
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004154
—
LA
Enumeration date
02/01/2007
Last updated
09/19/2022
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