Healthcare Provider Details

I. General information

NPI: 1376551911
Provider Name (Legal Business Name): ANGELA MARY BRADY-FLEMING FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 NORTHRIDGE PARK DR
RURAL HALL NC
27045-9575
US

IV. Provider business mailing address

5500 MARYLAND WAY STE 400
BRENTWOOD TN
37027-7048
US

V. Phone/Fax

Practice location:
  • Phone: 336-519-6445
  • Fax: 336-519-0660
Mailing address:
  • Phone: 336-519-6456
  • Fax: 336-519-0660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201852
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: