Healthcare Provider Details

I. General information

NPI: 1366213159
Provider Name (Legal Business Name): BRANDON CURTIS TUMEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5266 COMMERCE ST
SAINT FRANCISVILLE LA
70775-4409
US

IV. Provider business mailing address

9454 HARDWOOD DR
BATON ROUGE LA
70818-4715
US

V. Phone/Fax

Practice location:
  • Phone: 225-635-3811
  • Fax:
Mailing address:
  • Phone: 225-337-1364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN152982
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number234109
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: