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NPI Code Detail

MEDICARE: MRS. SYDNEY SLATTERY BRANNOCK NP

MEDICARE: MRS. SYDNEY SLATTERY BRANNOCK NP
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
1363LW0102XWomen's Health Nurse Practitioner5023511NC
2163W00000XRegistered Nurse338858NC
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1942922968
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SYDNEY SLATTERY BRANNOCK NP
Provider Business Mailing Address
First Line : 5960 FAIRVIEW RD STE 500
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3113
Country : US
Telephone Number : 704-495-6334
Fax Number :
Provider Business Practice Location Address
First Line : 330 BILLINGSLEY RD STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-3096
Country : US
Telephone Number : 704-495-6334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2022
Last Update Date : 12/10/2025

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