Brent Fondshay Broome, CNA

Individual provider Active NPI Attendant Care Provider · Moselle, MS

NPI 1144548744 · NPPES record last updated Jan 17, 2026

Key facts

NPI
1144548744
Entity type
Individual (NPI type 1)
Primary specialty
Attendant Care Provider 3747A0650X
Practice address
6 David Patterson Rd
Moselle, MS 39459
Phone
(601) 596-3786
NPI assigned
May 7, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X MS
Attendant Care Provider 3747A0650X MS Yes

Addresses

Primary practice location

6 David Patterson Rd
Moselle, MS 39459

Mailing address

6 David Patterson Rd
Moselle, MS 39459-9439
Phone (601) 596-3786

Other providers in Moselle, MS

All providers in Moselle, MS · Attendant Care Provider in Mississippi

Sources for this page

Verify at the official NPI Registry.