MEDICARE: BRIANNA KING NTP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach		NC

General Provider Information

NPI Number	:	1477267128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA KING NTP

Provider Business Mailing Address
First Line	:	7222 JANSTON DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-1082
Country	:	US
Telephone Number	:	781-927-9889
Fax Number	:

Provider Business Practice Location Address
First Line	:	7222 JANSTON DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-1082
Country	:	US
Telephone Number	:	781-927-9889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	01/09/2023

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