Provider Demographics
NPI:1013547553
Name:FORE, BRENDA CHERYL (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:CHERYL
Last Name:FORE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-0406
Mailing Address - Country:US
Mailing Address - Phone:828-560-3400
Mailing Address - Fax:828-538-4441
Practice Address - Street 1:997 OLD US HWY 70 W STE A
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-4505
Practice Address - Country:US
Practice Address - Phone:828-298-7981
Practice Address - Fax:828-298-6010
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012974363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNNB202AOtherMEDICARE
NC2089VOtherBCBS NC
NCP02457852OtherRAILROAD MEDICARE
NC1013547553Medicaid
NC2776095OtherCIGNA