MEDICARE: MR. BRANDON D FOUTCH ARNP, FNP-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
1	363LF0000X	Family Nurse Practitioner	ARNP9258198	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CM292Z	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	363LF0000X	OTHER	FL	NURSE PRACTITIONER-FAMILY
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184957805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRANDON D FOUTCH ARNP, FNP-BC

Provider Business Mailing Address
First Line	:	1910 HILLBROOKE TRL STE 2
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32311-7914
Country	:	US
Telephone Number	:	850-878-2637
Fax Number	:	877-502-2767

Provider Business Practice Location Address
First Line	:	1910 HILLBROOKE TRL STE 2
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32311-7914
Country	:	US
Telephone Number	:	850-878-2637
Fax Number	:	850-220-1849

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2009
Last Update Date	:	02/18/2022

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Directions to “ MR. BRANDON D FOUTCH ARNP, FNP-BC” Practice Location

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