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BRAD H MASSEY AACNP, ANP

Acute Care >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1164537445

Individual Registrant:
 BRAD H MASSEY AACNP, ANP
Gender: M
Sole Proprietor

Location and contact information for practice:
348 KNIGHT RD  SUMRALL, MS 39482-3702 US
Tel: 601-606-6326  Fax: --

Contact information for business:
348 KNIGHT ROAD  SUMRALL, MS 39482 US
Tel: 601-606-6326  Fax: --

Registration Information:
NPI: 1164537445
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LA2100XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Acute Care
MSR814032

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
AMERICAN ADMIN GROUP640507572POMS01
1582531LA05
00124846MS05




HEALTH CARE JOBS MS - Page 1



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