Provider Demographics
NPI:1356648190
Name:BRITT, ASHLEY RENEE (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:BRITT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 ERWIN RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4699
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2380 W ARLINGTON BLVD
Practice Address - Street 2:ECU PHYSICIANS EMERGENCY MEDICINE AT MED DIRECT
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2846
Practice Address - Country:US
Practice Address - Phone:252-847-0100
Practice Address - Fax:252-744-0128
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02774363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8101353Medicaid
NC8101353Medicaid