Individual
BREANNE PARKS
Active
Individual
BREANNE PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P15014
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9614
PHYSICAL THERAPY LICENSE
SC
01
—
P15014
STATE LICENSE
NC
Enumeration date
02/22/2011
Last updated
06/26/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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