Healthcare Provider Details

I. General information

NPI: 1083485858
Provider Name (Legal Business Name): BRITTNEY SIERRA GRIMM-WASH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTNEY SIERRA MASON NP

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CABARRUS AVE E STE 200
CONCORD NC
28025-3781
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 855-743-2247
  • Fax:
Mailing address:
  • Phone: 704-210-5260
  • Fax: 704-210-5265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5019409
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019409
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: