Provider Demographics
NPI:1871518308
Name:BRANN, BRANIGAN TREAT (PA-C)
Entity type:Individual
Prefix:
First Name:BRANIGAN
Middle Name:TREAT
Last Name:BRANN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 W ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5704
Mailing Address - Country:US
Mailing Address - Phone:252-752-6101
Mailing Address - Fax:252-752-6600
Practice Address - Street 1:1850 W ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5704
Practice Address - Country:US
Practice Address - Phone:252-413-6678
Practice Address - Fax:252-215-2905
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00698363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC186A9OtherBCBS NC
NC1871518308Medicaid
NC186A9OtherBCBS NC