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Individual

ERIN RUTH BRABANDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1105 FAIRGROVE CHURCH RD SE, CONOVER, NC 28613-9090
(828) 267-0551
Mailing address
1024 30TH AVE LANE NE, HICKORY, NC 28601
(720) 989-4565

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
102916
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102916
LICENSURE
NC
01
1623
STATES LICENSE NUMBER
CO
Enumeration date
11/20/2006
Last updated
12/28/2012
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