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General NPI Number Information
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NPI Number | 1861749822
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Entity Type | Individual
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Provider Name | ADRIANE J BRACKETT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 311 EAST WILSON AVENUE CAMPUS BOX 3087 (SCHOOL OF PHARMACY)
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City | WINGATE
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State | NC
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Zip | 28174
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Country | US
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Telephone | 704-233-8625
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Fax |
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Provider Business Mailing Address
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Address Line | 5135 SUMMERELL AVE
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City | GASTONIA
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State | NC
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Zip | 28056-8582
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Country | US
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Telephone | 704-473-5483
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 22484
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License Number State | NC
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