Provider Demographics
NPI:1780309153
Name:ALBRITTON, CONNIE J
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:J
Last Name:ALBRITTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2375 VINEYARD DR APT H6
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9570
Mailing Address - Country:US
Mailing Address - Phone:252-702-3534
Mailing Address - Fax:
Practice Address - Street 1:2375 VINEYARD DR APT H6
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-9570
Practice Address - Country:US
Practice Address - Phone:252-702-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company