Provider Demographics
NPI:1801527775
Name:BRUMFIELD, BRYAN (RN,RVT,RDCS,RRT,BS)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:BRUMFIELD
Suffix:
Gender:M
Credentials:RN,RVT,RDCS,RRT,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 THATCHER LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-6539
Mailing Address - Country:US
Mailing Address - Phone:318-348-1931
Mailing Address - Fax:
Practice Address - Street 1:204 THATCHER LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-6539
Practice Address - Country:US
Practice Address - Phone:318-348-1931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA210785163WA0400X
RRT.L03281227900000X
LA1148182085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered