Healthcare Provider Details

I. General information

NPI: 1831715127
Provider Name (Legal Business Name): BRITTANY MOORE PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 CHESTNUT RIDGE PKWY
BLOWING ROCK NC
28605-8962
US

IV. Provider business mailing address

105 39TH AVENUE PL NW
HICKORY NC
28601-8029
US

V. Phone/Fax

Practice location:
  • Phone: 828-312-7557
  • Fax:
Mailing address:
  • Phone: 828-312-7557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: