Healthcare Provider Details

I. General information

NPI: 1508009382
Provider Name (Legal Business Name): BETHANY BRELAND CASE MSN,WHNP-BC, AGNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 DOMINICAN DR
MADISON MS
39110-8630
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 601-200-7300
  • Fax:
Mailing address:
  • Phone: 601-200-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number860365
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number860365
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: