Healthcare Provider Details

I. General information

NPI: 1316547888
Provider Name (Legal Business Name): BRITTANY EDMONSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4220
US

IV. Provider business mailing address

508 S PERSON ST APT 103
RALEIGH NC
27601-1876
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-5101
  • Fax:
Mailing address:
  • Phone: 253-740-4745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number274762
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: