| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KENNITRISH NICKOLA BRACEY | 1295334647 | 2020-10-17 |
Kennitrish Nickola Bracey is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1295334647. Registration indicates Kennitrish Nickola Bracey is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Primary Care, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Primary Care, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Kennitrish Nickola Bracey DNP, APRN, AGNP-C |
| Practice Office Address | 1131 N CHURCH ST GREENSBORO, NC US |
| Practice Office Telephone | 9728814688 |
| Mailing Address | 1131 N CHURCH ST GREENSBORO, NC 274011015 US |
| Business Telephone | 3364560429 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 5124 Red Poll Dr | Greensboro, NC 274059794 | 3364560429 |
| 705 Sharing Ter | Greensboro, NC 274058670 | 1336456042 |
| Code | Practice | License No State |
|---|---|---|
| 363LP2300X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Primary Care All Other Specialties & Provider Types Nurse Practitioner Primary Care Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 5014047
NC |