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General NPI Number Information
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NPI Number | 1568976413
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Entity Type | Individual
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Provider Name | BRANDIE A SMITH FNP
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Gender | Female
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 201 HOLIDAY BLVD STE 400
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City | COVINGTON
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State | LA
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Zip | 70433-5282
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Country | US
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Telephone | 504-677-8474
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Fax | 504-677-8474
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Provider Business Mailing Address
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Address Line | 241 THORNWOOD DR
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City | COVINGTON
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State | LA
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Zip | 70435-0285
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Country | US
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Telephone | 504-234-0627
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 452815734
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP09279
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | AP09279
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License Number State | LA
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