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Individual

MS. KELLY A THOMPSON-BRAZILL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
2100 STANTONSBURG RD, TRAUMA & SURGICAL CRITICAL CARE, 2ND FLOOR ED TOWER, GREENVILLE, NC 27834-2818
(252) 847-4299
(252) 847-8208
Mailing address
3208 ENCHANTING WAY, RALEIGH, NC 27616-8372
(919) 752-0153

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
960051
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7003697
NC
Enumeration date
12/29/2005
Last updated
07/08/2007
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