Healthcare Provider Details

I. General information

NPI: 1497571517
Provider Name (Legal Business Name): BRIANNA ROSE CATALANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 MATTHEWS MINT HILL RD
MATTHEWS NC
28105-3605
US

IV. Provider business mailing address

3610 MATTHEWS MINT HILL RD
MATTHEWS NC
28105-3605
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16463
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: