MEDICARE: MS. BRANDY BRUMFIELD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	81663001	NY
2	164W00000X	Licensed Practical Nurse	5202272	FL
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1447692033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRANDY BRUMFIELD

Provider Business Mailing Address
First Line	:	4 MARPLE LANE
Second Line	:	APT. D
City	:	HILTON
State	:	NY
Zip	:	14468-3774
Country	:	US
Telephone Number	:	706-284-4443
Fax Number	:

Provider Business Practice Location Address
First Line	:	4280 BUTTERNUT PLACE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-3034
Country	:	US
Telephone Number	:	404-480-4116
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	10/31/2023

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