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Contact Information

BRANDON B TELLER, FNP-C
2100 US-61 N
VICKSBURG, MS39183-4500
 Phone: 601-415-6161
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Critical Care Medicine

163WC0200X
Indicates primary specialty

NPI Profile & details for BRANDON B TELLER · (Male)

NPI Number 1285477018
Status Active
Credentials FNP-C (Family Nurse Practitioner, Certified)
Entity Individual
Enumeration date 06/18/2024
Last updated 07/16/2025 - About 11 months ago
Sole proprietor 1 Yes
Identifiers
  • MS License # 918907
  • MS License # F07250420
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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