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Individual

BRENDA JEAN JUSTICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
125 E MAIN ST, BENSON, NC 27504-1506
(919) 894-3321
(919) 894-8742
Mailing address
125 E MAIN ST, BENSON, NC 27504-1506
(919) 894-3321
(919) 894-8742

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363AM0700X
Medical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
012Y9
BLUE CROSS/BLUE SHIELD
NC
01
179133
WELLPATH
NC
01
3604325
CIGNA
NC
01
7389999
MAMSI
NC
05
89012Y9
NC
05
89014KX
NC
Enumeration date
09/07/2007
Last updated
09/07/2007
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