Healthcare Provider Details

I. General information

NPI: 1285564203
Provider Name (Legal Business Name): JANICE D BRUMFIELD LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 WHITE ST
MCCOMB MS
39648-2711
US

IV. Provider business mailing address

PO BOX 18679 4100 MAMIE STREET
HATTIESBURG MS
39404-8679
US

V. Phone/Fax

Practice location:
  • Phone: 769-217-2810
  • Fax: 601-324-5559
Mailing address:
  • Phone: 601-705-1901
  • Fax: 601-705-1952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number325282
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: