Individual
BRANDILYN RENE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1020 HIGHWAY 62 E, MOUNTAIN HOME, AR 72653-3216
(870) 337-2172
Mailing address
609 BRUNSON DR STE B, TUPELO, MS 38801-4948
(662) 432-1097
(833) 707-1951
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2023192642
MS
363LF0000X
Family Nurse Practitioner
905144
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2023192642
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
232613
AR
363LP2300X
Primary Care Nurse Practitioner
905144
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03851554
—
MS
Enumeration date
02/07/2022
Last updated
05/01/2025
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