Provider Demographics
NPI:1306295332
Name:BRUMLEY, MARISA (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:BRUMLEY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:PALMO
Other - Last Name:BRUMLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:124 CHANDLER LN
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77320-1626
Mailing Address - Country:US
Mailing Address - Phone:936-662-6357
Mailing Address - Fax:
Practice Address - Street 1:1020 RIVERWOOD CT STE 200
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2974
Practice Address - Country:US
Practice Address - Phone:936-756-3444
Practice Address - Fax:936-756-3452
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily