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NPI Code Detail

MEDICARE: MRS. KELLY MULLIGAN BRITT P.A.-C

MEDICARE: MRS. KELLY MULLIGAN BRITT P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant001000116NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1001000116OTHERNCSTATE LIC

General Provider Information

NPI Number : 1477511848
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLY MULLIGAN BRITT P.A.-C
Provider Business Mailing Address
First Line : 1099 MEDICAL CENTER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7346
Country : US
Telephone Number : 910-251-9944
Fax Number : 910-763-4666
Provider Business Practice Location Address
First Line : 1099 MEDICAL CENTER DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7346
Country : US
Telephone Number : 910-251-9944
Fax Number : 910-763-4666
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 11/08/2011

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