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NPI Code Detail

MEDICARE: MRS. SHIRLEY JEAN BRISCO PMHNP-BC

MEDICARE:  MRS. SHIRLEY JEAN BRISCO  PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered NurseRN075082LA

General Provider Information

NPI Number : 1174791750
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHIRLEY JEAN BRISCO PMHNP-BC
Provider Business Mailing Address
First Line : 44 VERSAILLES BLVD
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-3960
Country : US
Telephone Number : 318-445-5111
Fax Number : 318-442-2261
Provider Business Practice Location Address
First Line : 44 VERSAILLES BLVD
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-3960
Country : US
Telephone Number : 318-445-5111
Fax Number : 318-442-2261
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2008
Last Update Date : 10/31/2011

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Directions to “ MRS. SHIRLEY JEAN BRISCO PMHNP-BC” Practice Location

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