Individual
MS. BRANDY R PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Mailing address
9107 REDWING CT, SHREVEPORT, LA 71115-3605
(318) 840-9660
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN085735-AP0589
LA
363LF0000X
Family Nurse Practitioner
RN085735-AP05893
LA
Other
Enumeration date
08/28/2009
Last updated
04/01/2013
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