Provider Demographics
NPI:1942635586
Name:BRINSON, ELIZABETH GWEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:GWEN
Last Name:BRINSON
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 1:322 SUMMERSET DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-6827
Mailing Address - Country:US
Mailing Address - Phone:828-674-3530
Mailing Address - Fax:
Practice Address - Street 1:165 COOLRIDGE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-2767
Practice Address - Country:US
Practice Address - Phone:828-697-1592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC133211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC600685986OtherPRIVATE PAY