Individual
KIRSTEN NICOLE BRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1617 W GARRISON BLVD, GASTONIA, NC 28052-3635
(704) 867-0219
(704) 867-0216
Mailing address
PO BOX 98313, RALEIGH, NC 27624-8313
(919) 845-0054
(919) 845-1947
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200100315
NC
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
2001-00315
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8910429
—
NC
Enumeration date
10/07/2005
Last updated
06/30/2017
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