Individual
BRANDON WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
306 COLLEGE ST, WILKESBORO, NC 28697-2854
(336) 651-7533
Mailing address
306 COLLEGE ST, WILKESBORO, NC 28697-2854
(336) 651-7533
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5012336
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962565788
—
NC
Enumeration date
10/10/2019
Last updated
10/10/2019
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