MEDICARE: BRITTANY MANN

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	363A00000X	Physician Assistant	001011721	NC

General Provider Information

NPI Number	:	1518550326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY MANN

Provider Business Mailing Address
First Line	:	4545 SUGARBERRY DR APT 931
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-2441
Country	:	US
Telephone Number	:	240-528-0434
Fax Number	:

Provider Business Practice Location Address
First Line	:	416 MCCULLOUGH DR STE 140
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4390
Country	:	US
Telephone Number	:	704-536-0073
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2021
Last Update Date	:	04/24/2026

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Directions to “ BRITTANY MANN ” Practice Location

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