Individual
SUSAN C BRAME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9066 HIGHLAND ST, OLIVE BRANCH, MS 38654-2307
(662) 890-7717
(662) 874-6038
Mailing address
9066 HIGHLAND ST, OLIVE BRANCH, MS 38654-2307
(662) 890-7717
(662) 874-6038
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R644986
MS
363LF0000X
Family Nurse Practitioner
Primary
R644986
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121759
—
MS
Enumeration date
04/18/2006
Last updated
03/07/2023
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