Provider Demographics
NPI:1629228374
Name:JOINES, BRELAND MEANY (PA-C)
Entity Type:Individual
Prefix:
First Name:BRELAND
Middle Name:MEANY
Last Name:JOINES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRELAND
Other - Middle Name:M
Other - Last Name:JOINES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 HICKORY BRANCH DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9601
Practice Address - Country:US
Practice Address - Phone:336-878-2260
Practice Address - Fax:336-878-2277
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02695363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1629228374Medicaid
VAP00637891OtherMEDICARE RAILROAD
VA1629228374Medicaid