Active NPI
Brandi Tynes
- Family Nurse Practitioner
- Laurel, MS
National Provider Identifier
1639547425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP 901423
- Practice address
- 1410 Jefferson St
Laurel, MS 39440-4243 - Phone
- (601) 425-7522
- Fax
- (601) 649-3551
- NPI assigned
- Sep 10, 2015
- Last updated
- Jan 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP 901423 | MS | Primary |
Addresses
Primary practice location
1410 Jefferson St
Laurel, MS 39440-4243
Mailing address
PO Box 247
Laurel, MS 39441-0247
Phone (601) 425-7550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453334400000",
"number": "1639547425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 247",
"city": "LAUREL",
"state": "MS",
"postal_code": "394410247",
"telephone_number": "601-425-7550",
"fax_number": "601-399-6281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1410 JEFFERSON ST",
"city": "LAUREL",
"state": "MS",
"postal_code": "394404243",
"telephone_number": "601-425-7522",
"fax_number": "601-649-3551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYNES",
"first_name": "BRANDI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-10",
"last_updated": "2016-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "NP 901423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.