Provider Demographics
NPI:1679691893
Name:BRASWELL, SHARON G (RPH)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:G
Last Name:BRASWELL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 STONEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-9390
Mailing Address - Country:US
Mailing Address - Phone:919-553-0144
Mailing Address - Fax:919-550-0829
Practice Address - Street 1:11360 US HIGHWAY 70 W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2206
Practice Address - Country:US
Practice Address - Phone:919-553-0144
Practice Address - Fax:919-550-0829
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist