Healthcare Provider Details

I. General information

NPI: 1851237663
Provider Name (Legal Business Name): BRIANA DIANE PUCHEU FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 HARVEST DR
BILOXI MS
39532-8775
US

IV. Provider business mailing address

8301 HARVEST DR
BILOXI MS
39532-8775
US

V. Phone/Fax

Practice location:
  • Phone: 228-343-8466
  • Fax:
Mailing address:
  • Phone: 228-343-8466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number908313
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: