Individual provider · Type 1 NPI

Brandon Blake Teller, FNP-C

Family Nurse Practitioner · Vicksburg, MS

NPI number 1285477018 Active

Practice location

2100 US-61 N
Vicksburg, MS 39183-4500

Call (601) 415-6161 Map

Mailing address

2100 US-61N
Vicksburg, MS 39183-6094

Specialties and licenses

TaxonomyCodeLicense
Critical Care Medicine Registered Nurse 163WC0200X918907 (MS)
Family Nurse Practitioner Primary 363LF0000XF07250420 (MS)

Family Nurse Practitioner: Definition to come...

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About NPI 1285477018

Brandon Blake Teller, FNP-C's National Provider Identifier is 1285477018, issued on Jun 18, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Vicksburg, MS. The record was last updated on Jul 16, 2025.