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General NPI Number Information
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NPI Number | 1396460101
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Entity Type | Individual
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Provider Name | LANCE MICHAEL BRUMLEY NP
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Gender | Male
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 425 W OAK ST
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City | EL DORADO
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State | AR
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Zip | 71730-4566
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Country | US
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Telephone | 870-863-5153
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Fax |
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Provider Business Mailing Address
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Address Line | 164 ADDIE LN
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City | EL DORADO
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State | AR
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Zip | 71730-5029
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Country | US
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Telephone | 870-866-6609
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 221886
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License Number State | AR
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