MEDICARE: DIVINE AUTHORITY HEALTH AND WELLNESS, PLLC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1609725506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE AUTHORITY HEALTH AND WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	205 TWILIGHT DR
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-8393
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 TWILIGHT DR
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-8393
Country	:	US
Telephone Number	:	919-222-4874
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MS. BRITTANY VIERA
Credential	:	NP
Telephone Number	:	919-222-4874

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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