Provider Demographics
NPI:1447794938
Name:SCULLIN, BRIGID MARRIE (DNP)
Entity type:Individual
Prefix:
First Name:BRIGID
Middle Name:MARRIE
Last Name:SCULLIN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5507 WESTON DOWNS DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-9216
Mailing Address - Country:US
Mailing Address - Phone:919-537-2076
Mailing Address - Fax:
Practice Address - Street 1:321 ARCH STREET
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-4220
Practice Address - Country:US
Practice Address - Phone:814-333-7109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027150363LA2200X
NC5009126363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health