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General NPI Number Information
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NPI Number | 1629674866
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Entity Type | Individual
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Provider Name | BRITTNEY NICOLE BOHREN PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 40 MEDICINE CIRCLE
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City | DURHAM
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State | NC
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Zip | 27710-0001
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Country | US
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Telephone | 919-684-3235
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Fax |
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Provider Business Mailing Address
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Address Line | 304 GLADSTONE DR
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City | DURHAM
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State | NC
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Zip | 27703-2751
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Country | US
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Telephone | 970-759-8747
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 0010-10699
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License Number State | NC
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