Madeline Gautreaux Brence, PHYSICIAN ASSISTANT

Individual provider Active NPI Physician Assistant · Clemmons, NC

NPI 1427807635 · NPPES record last updated May 20, 2024

Key facts

NPI
1427807635
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
3215 Turnstone CT
Clemmons, NC 27012-8585
Phone
(336) 529-0443
NPI assigned
May 18, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kidzcare Pediatrics, PC Past Accepting new patients
Kidzcare Pediatrics, PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Yes

Addresses

Primary practice location

3215 Turnstone CT
Clemmons, NC 27012-8585

Mailing address

3215 Turnstone CT
Clemmons, NC 27012-8585
Phone (336) 529-0443

Other providers in Clemmons, NC

All providers in Clemmons, NC · Physician Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.