Provider Demographics
NPI:1134607484
Name:RAY LANDRY, BRANDI MICHELLE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:MICHELLE
Last Name:RAY LANDRY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:BRANDI
Other - Middle Name:MICHELLE
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:PO BOX 6071
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70009-6071
Mailing Address - Country:US
Mailing Address - Phone:504-382-0825
Mailing Address - Fax:
Practice Address - Street 1:9605 JEFFERSON HWY STE G
Practice Address - Street 2:
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123-2550
Practice Address - Country:US
Practice Address - Phone:504-739-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP10156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily