Healthcare Provider Details

I. General information

NPI: 1528932092
Provider Name (Legal Business Name): BRANDY GREER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 HIGHLAND COLONY PKWY STE 105
RIDGELAND MS
39157-8843
US

IV. Provider business mailing address

103 GRANDWOOD DR
CANTON MS
39046-4046
US

V. Phone/Fax

Practice location:
  • Phone: 601-707-3737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number907796
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: