Individual
BRANDI B KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
14884 HWY 15, DECATUR, MS 39327
(601) 635-2258
(601) 635-2259
Mailing address
PO BOX 2106, MERIDIAN, MS 39302-2106
(601) 703-4282
(601) 703-4597
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R869775
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08508350
—
MS
Enumeration date
12/17/2007
Last updated
11/06/2013
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