Healthcare Provider Details

I. General information

NPI: 1700065570
Provider Name (Legal Business Name): DONNA JILL BRANTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1870
COVINGTON LA
70434-1870
US

IV. Provider business mailing address

PO BOX 1870
COVINGTON LA
70434-1870
US

V. Phone/Fax

Practice location:
  • Phone: 985-256-5599
  • Fax:
Mailing address:
  • Phone: 985-256-5599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP04581
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: