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General NPI Number Information
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NPI Number | 1457997553
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Entity Type | Individual
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Provider Name | NOEL BRASSETT NP
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Gender | Female
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Dates
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Enumeration Date | 11/23/2019
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 1173 FRONT ST
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City | SAN DIEGO
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State | CA
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Zip | 92101-3904
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Country | US
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Telephone | 619-610-1647
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Fax |
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Provider Business Mailing Address
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Address Line | 714 WOODVIEW CT
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City | BATON ROUGE
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State | LA
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Zip | 70810-5336
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Country | US
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Telephone | 225-978-7866
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95024102
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-174112
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License Number State | AL
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