Provider Demographics
NPI:1821682592
Name:BRUMFIELD, DANNY
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:BRUMFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 DONNA DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-3511
Mailing Address - Country:US
Mailing Address - Phone:504-516-1595
Mailing Address - Fax:
Practice Address - Street 1:4949 DONNA DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3511
Practice Address - Country:US
Practice Address - Phone:504-516-1595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA009493441172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver