Healthcare Provider Details

I. General information

NPI: 1073423810
Provider Name (Legal Business Name): BRIANNA DORO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 HUFF DR
JACKSONVILLE NC
28546-7369
US

IV. Provider business mailing address

270 CROSSROADS STORE DR
JACKSONVILLE NC
28546-0129
US

V. Phone/Fax

Practice location:
  • Phone: 910-353-4414
  • Fax:
Mailing address:
  • Phone: 708-408-0952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF08260930
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: