Healthcare Provider Details

I. General information

NPI: 1356011373
Provider Name (Legal Business Name): BRAEDYN ASHLEIGH MCCURRY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 12/31/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 THETFORD ST STE 120
ASHEVILLE NC
28803-5065
US

IV. Provider business mailing address

PO BOX 604333
CHARLOTTE NC
28260-4333
US

V. Phone/Fax

Practice location:
  • Phone: 828-378-5620
  • Fax: 828-378-5629
Mailing address:
  • Phone: 828-378-5620
  • Fax: 828-378-5629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5015093
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberMCCU-KY9FI
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: