Provider Demographics
NPI:1881926517
Name:SANDERS, BRITNEY KASEY (PA-C)
Entity type:Individual
Prefix:
First Name:BRITNEY
Middle Name:KASEY
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S WINGATE ST
Mailing Address - Street 2:SEBTS BOX BO-25-A
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:451 RUIN CREEK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2878
Practice Address - Country:US
Practice Address - Phone:252-492-9565
Practice Address - Fax:252-492-5373
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02187363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant