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Individual

DANA BRANTLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
5002 HIGHWAY 39 N BLDG C, MERIDIAN, MS 39301-1078
(601) 385-9111
(662) 328-1507
Mailing address
670 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 328-1012
(662) 328-1507

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP127550
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
903935
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
149328
MO LICENSE NUMBER
MO
05
364281101
TX
Enumeration date
10/28/2008
Last updated
03/10/2025
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