Healthcare Provider Details
I. General information
NPI: 1801202965
Provider Name (Legal Business Name): BRIANNA GLYNN-SERVEDIO PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/09/2014
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3305 SUNGATE BLVD
RALEIGH NC
27610-2871
US
IV. Provider business mailing address
3212 ENCHANTING WAY
RALEIGH NC
27616-8372
US
V. Phone/Fax
- Phone: 919-212-0129
- Fax: 919-255-1540
- Phone: 908-601-3800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 24231 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P0018X |
| Taxonomy | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| License Number | 24231 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: