MEDICARE: MR. TIMOTHY SCOTT BRISBIN FNP-C

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	363LP2300X	Primary Care Nurse Practitioner	5008651	NC

General Provider Information

NPI Number	:	1659721975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TIMOTHY SCOTT BRISBIN FNP-C

Provider Business Mailing Address
First Line	:	314 BLOWING ROCK BLVD
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-4406
Country	:	US
Telephone Number	:	828-237-2287
Fax Number	:

Provider Business Practice Location Address
First Line	:	314 BLOWING ROCK BLVD
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-4406
Country	:	US
Telephone Number	:	828-237-2287
Fax Number	:

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

Provider Enumeration Date	:	06/17/2016
Last Update Date	:	03/26/2025

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