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General NPI Number Information
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NPI Number | 1649423237
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Entity Type | Individual
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Provider Name | DANA BRANTLEY APN
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Gender | Female
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 5002 HIGHWAY 39 N BLDG C
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City | MERIDIAN
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State | MS
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Zip | 39301-1078
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Country | US
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Telephone | 601-385-9111
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Fax | 662-328-1507
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Provider Business Mailing Address
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Address Line | 670 LEIGH DR
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City | COLUMBUS
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State | MS
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Zip | 39705-3014
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Country | US
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Telephone | 662-328-1012
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Fax | 662-328-1507
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP127550
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 903935
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License Number State | MS
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