Shelly Dawn Brackett, RN

Individual provider Active NPI Home Health Agency · Spindale, NC

NPI 1386775005 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1386775005
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Agency 251E00000X
License
HC3484 (NC)
Practice address
1060 Old Ballpark Rd
Lot #1
Spindale, NC 28160-2084
Phone
(828) 288-1623
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
HC3484NCMDHome Health Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC3484 NC Yes

Addresses

Primary practice location

1060 Old Ballpark Rd
Lot #1
Spindale, NC 28160-2084

Mailing address

1060 Old Ballpark Rd
Lot #1
Spindale, NC 28160-2084
Phone (828) 288-1623

Other providers in Spindale, NC

All providers in Spindale, NC · Home Health Agency in North Carolina

Sources for this page

Verify at the official NPI Registry.