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NPI Code Detail

MEDICARE: TRACI RENEE BRAMLETT MSN, FNP-C

MEDICARE: TRACI RENEE BRAMLETT MSN, 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
1363LF0000XFamily Nurse Practitioner5006720NC

General Provider Information

NPI Number : 1831280361
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACI RENEE BRAMLETT MSN, FNP-C
Provider Business Mailing Address
First Line : 461 WESTERN BLVD STE 122
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-7637
Country : US
Telephone Number : 910-333-0283
Fax Number : 910-333-0513
Provider Business Practice Location Address
First Line : 461 WESTERN BLVD STE 122
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-7637
Country : US
Telephone Number : 910-333-0283
Fax Number : 910-333-0513
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 10/14/2024

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