Benjamin Kevin Bragg

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Cullowhee, NC

NPI 1992193072 · NPPES record last updated Dec 24, 2014

Key facts

NPI
1992193072
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
70 Westside Dr
Apt# 201
Cullowhee, NC 28723-1080
Phone
(865) 368-0054
NPI assigned
Dec 24, 2014
Sex
Male
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

70 Westside Dr
Apt# 201
Cullowhee, NC 28723-1080

Mailing address

70 Westside Dr
Apt# 201
Cullowhee, NC 28723-1080
Phone (865) 368-0054

Other providers in Cullowhee, NC

All providers in Cullowhee, NC · Student in an Organized Health Care Education/Training Program in North Carolina

Sources for this page

Verify at the official NPI Registry.