MEDICARE: CHAMPION FAMILY MEDICAL & WELLNESS

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

General Provider Information

NPI Number	:	1407121395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMPION FAMILY MEDICAL & WELLNESS

Provider Business Mailing Address
First Line	:	303B HIGHWAY 90
Second Line	:
City	:	BAY ST LOUIS
State	:	MS
Zip	:	39520-2832
Country	:	US
Telephone Number	:	228-467-4431
Fax Number	:	228-467-4443

Provider Business Practice Location Address
First Line	:	303B HIGHWAY 90
Second Line	:
City	:	BAY ST LOUIS
State	:	MS
Zip	:	39520-2832
Country	:	US
Telephone Number	:	228-467-4431
Fax Number	:	228-467-4443

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	BRANDON CHAMPION
Credential	:
Telephone Number	:	251-610-4041

Provider Enumeration Date	:	03/12/2012
Last Update Date	:	03/12/2012

Similar Medicare Providers

1790727378 — MS. LESLIE DENISE LCSW
Practice Location Address:

303 HIGHWAY 90
BAY SAINT LOUIS, MS
39520-2832

Practice Phone: 228-471-3141
Practice Fax:

1801174230 — CHAMPION FAMILY MEDICAL & WELLNESS CENTER- URGENT CARE
Practice Location Address:

303B HIGHWAY 90
BAY ST LOUIS, MS
39520-2832

Practice Phone: 228-467-4431
Practice Fax: 228-467-4443

1902448723 — LESLIE THERAPY, LLC
Practice Location Address:

303 HIGHWAY 90
BAY SAINT LOUIS, MS
39520-2832

Practice Phone: 228-471-3141
Practice Fax:

1104461417 — CHRISTINA B JAMES LCSW
Practice Location Address:

303 HIGHWAY 90
BAY SAINT LOUIS, MS
39520-2832

Practice Phone: 228-238-0992
Practice Fax:

1235774589 — LIGHTHOUSE COUNSELING, PLLC
Practice Location Address:

303 HIGHWAY 90
BAY SAINT LOUIS, MS
39520-2832

Practice Phone: 228-238-0992
Practice Fax:

1497998652 — LAURA EBNER MD
Practice Location Address:

2238A BAY RIDGE AVE
ANNAPOLIS, MD
21403-2832

Practice Phone: 410-635-0465
Practice Fax:

Directions to “CHAMPION FAMILY MEDICAL & WELLNESS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.