Provider Demographics
NPI:1881301265
Name:HUNTER, BRANDY ELAINE (ACNPC-AG, FNP-C)
Entity type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:ELAINE
Last Name:HUNTER
Suffix:
Gender:
Credentials:ACNPC-AG, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 GRAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-9371
Mailing Address - Country:US
Mailing Address - Phone:318-455-0277
Mailing Address - Fax:
Practice Address - Street 1:4526 NORTHPORT BLVD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-2536
Practice Address - Country:US
Practice Address - Phone:318-489-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140280363LA2100X, 363LF0000X
LA226914363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care