Individual
BRANDY WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
2500 N STATE ST, DEPT OF NEUROSURGERY, JACKSON, MS 39216-4500
(601) 984-5706
(601) 984-6439
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5706
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R877216
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06175811
—
MS
05
—
191033
—
AL
Enumeration date
11/09/2011
Last updated
10/04/2016
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