Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 4466 | NC |
Y | 213EG0000X | General Practice | 4466 | NC |
NPI | 1003908948 |
---|---|
Provider Name | Dawn Gilmore Brannon |
First Address | Rockingham, NC 28379-5210 |
Second Address | Rockingham, NC 28379-5210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8991061 | (05) | NC |