Individual
BRANDI RAWLS LOCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, RNFA
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5459
(601) 268-5733
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5459
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
871360
MS
363L00000X
Nurse Practitioner
R871360
MS
363LF0000X
Family Nurse Practitioner
Primary
871360
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06136312
MAGNOLIA HEALTH PLAN
MS
05
—
06136312
—
MS
01
—
3310161
UNITED HEALTHCARE
MS
01
—
9779665
AETNA
MS
01
—
P00974930
RAILROAD MEDICARE
MS
Enumeration date
04/13/2011
Last updated
07/23/2020
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