Provider Demographics
NPI:1245413640
Name:BRIGMAN, LESTER JR (APRN BC FNP, PPCNP)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:
Last Name:BRIGMAN
Suffix:JR
Gender:M
Credentials:APRN BC FNP, PPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 ELIZABETH AVE
Mailing Address - Street 2:#200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2534
Mailing Address - Country:US
Mailing Address - Phone:704-910-1402
Mailing Address - Fax:
Practice Address - Street 1:1523 ELIZABETH AVE
Practice Address - Street 2:#200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2534
Practice Address - Country:US
Practice Address - Phone:704-910-1402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3407363LF0000X
NC5003979363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1211Medicaid
SCAA26071850Medicare PIN
SCAA26071879Medicare PIN
SCAA26077977Medicare PIN