MEDICARE: BRITTNEY NICOLE CHAMPAGNE PHARMD

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	700308	NC
2	1835P2201X	Ambulatory Care Pharmacist	28114	NC

General Provider Information

NPI Number	:	1528535085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY NICOLE CHAMPAGNE PHARMD

Provider Business Mailing Address
First Line	:	5102 N ROXBORO ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-1420
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5102 N ROXBORO ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-1420
Country	:	US
Telephone Number	:	585-469-5015
Fax Number	:

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

Provider Enumeration Date	:	11/01/2018
Last Update Date	:	04/15/2026

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