Provider Demographics
NPI:1033267752
Name:BRINN, PAMELA LYNN (CNM)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:LYNN
Last Name:BRINN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3222
Mailing Address - Country:US
Mailing Address - Phone:252-940-6539
Mailing Address - Fax:252-946-8430
Practice Address - Street 1:1436 HIGHLAND DRIVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3222
Practice Address - Country:US
Practice Address - Phone:252-940-6539
Practice Address - Fax:252-946-8430
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019470363LF0000X
NC326367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ01903Medicare UPIN
NC2590881BMedicare PIN