Healthcare Provider Details

I. General information

NPI: 1518282359
Provider Name (Legal Business Name): JUDY NEUBRANDER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUDY MALLORY

II. Dates (important events)

Enumeration Date: 04/05/2010
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 SWEETEN CREEK RD
ASHEVILLE NC
28803-2318
US

IV. Provider business mailing address

68 SWEETEN CREEK RD
ASHEVILLE NC
28803-2318
US

V. Phone/Fax

Practice location:
  • Phone: 828-274-2400
  • Fax: 828-777-3389
Mailing address:
  • Phone: 828-274-2400
  • Fax: 828-777-3389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5004668
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: