Individual
MR. ANDREW RONALD BRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1210 NEW GARDEN RD, GREENSBORO, NC 27410
(336) 294-6190
(336) 294-6278
Mailing address
3305 FARM LAKE ST, JAMESTOWN, NC 27282-7514
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
269582
NC
363L00000X
Nurse Practitioner
Primary
269582
NC
363LF0000X
Family Nurse Practitioner
269582
NC
Other
Enumeration date
02/08/2018
Last updated
11/13/2024
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