Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 5005989 | NC |
NPI | 1023354024 |
---|---|
Provider Name | Mrs. Anna Sullivan Bruton |
First Address | Morrisville, NC 27560-8442 |
Second Address | Clayton, NC 27520-4497 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2012 |
Last Update Date | 06/05/2021 |