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General NPI Number Information
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NPI Number | 1124380274
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Entity Type | Individual
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Provider Name | COLLEEN MEGAN BRANDSEMA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2012
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 1909 N CHURCH ST
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City | BURLINGTON
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State | NC
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Zip | 27217-2926
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Country | US
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Telephone | 336-227-5506
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Fax |
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Provider Business Mailing Address
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Address Line | 1704 OAK TREE DR
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City | CHAPEL HILL
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State | NC
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Zip | 27517-4061
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Country | US
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Telephone | 336-491-4212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22435
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License Number State | NC
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