Individual
KENNITRISH NICKOLA BRACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, AGNP-C
Contact information
Practice address
1131 N CHURCH ST, GREENSBORO, NC 27401-1015
(972) 881-4688
Mailing address
1131 N CHURCH ST, GREENSBORO, NC 27401-1015
(336) 456-0429
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
5014047
NC
Other
Enumeration date
10/17/2020
Last updated
12/06/2023
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