Individual provider · Type 1 NPI
Brian Wade Pullam
Psychiatric/Mental Health Nurse Practitioner · Niceville, FL
NPI number
1770121535
Active
Practice location
1049 John Sims Pkwy E
Niceville, FL 32578-2754
Fax (850) 378-5237
Mailing address
1723 Pine Ave
Niceville, FL 32578-4600
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11005354 (FL) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | APRN11005354 (FL) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1770121535
Brian Wade Pullam's National Provider Identifier is 1770121535, issued on Dec 11, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Niceville, FL. The record was last updated on Aug 20, 2025.