Provider Demographics
NPI:1689266199
Name:BRASWELL, COURTNEY NELSON (NP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:NELSON
Last Name:BRASWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 BUFFALOE RD
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-5132
Mailing Address - Country:US
Mailing Address - Phone:919-710-1769
Mailing Address - Fax:
Practice Address - Street 1:550 NEW WAVERLY PL
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7412
Practice Address - Country:US
Practice Address - Phone:919-467-5941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014033363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health