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General NPI Number Information
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NPI Number | 1003534884
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Entity Type | Organization
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Legal Business Name | DR BRANDY M BAILLARGEON NURSE PRACTITIONER PSYCHIATRY PLLC
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 966 STATE HIGHWAY 37
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City | HAMMOND
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State | NY
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Zip | 13646-3280
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Country | US
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Telephone | 907-204-0894
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Fax |
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Provider Business Mailing Address
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Address Line | 966 STATE HIGHWAY 37
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City | HAMMOND
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State | NY
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Zip | 13646-3280
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Country | US
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Telephone | 907-204-0894
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER CEO
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Name | BRANDY M BAILLARGEON
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Credential | DR
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Telephone | 907-204-0894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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