Brianna Nicole Bumgarner, OTR/L

Individual provider Active NPI Occupational Therapist · Mocksville, NC

NPI 1578301511 · NPPES record last updated Jul 15, 2024

Key facts

NPI
1578301511
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
16663 (NC)
Practice address
498 Madison Rd
Mocksville, NC 27028-4249
Phone
(336) 751-3535
NPI assigned
Jul 15, 2024
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
16663NCMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 16663 NC Yes

Addresses

Primary practice location

498 Madison Rd
Mocksville, NC 27028-4249

Mailing address

498 Madison Rd
Mocksville, NC 27028-4249
Phone (336) 751-3535

Other providers in Mocksville, NC

All providers in Mocksville, NC · Occupational Therapist in North Carolina

Sources for this page

Verify at the official NPI Registry.