MEDICARE: BRANDI NUNEZ WASHINGTON FNP

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	363LF0000X	Family Nurse Practitioner	AP09491	LA

General Provider Information

NPI Number	:	1831613553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI NUNEZ WASHINGTON FNP

Provider Business Mailing Address
First Line	:	2301 MOSS ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-2125
Country	:	US
Telephone Number	:	337-706-7400
Fax Number	:	337-706-7444

Provider Business Practice Location Address
First Line	:	2301 MOSS ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-2125
Country	:	US
Telephone Number	:	337-706-7400
Fax Number	:	337-706-7444

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

Provider Enumeration Date	:	08/03/2017
Last Update Date	:	12/29/2020

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