GREENBRIAR PRIMARY CARE PA NPI 1477789147

NPI Information

  • NPI: 1477789147
  • Provider Name: GREENBRIAR PRIMARY CARE, PA
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 34D1100790
  • Address: 308-C MOCKSVILLE HIGHWAY
    STATESVILLE, NC
    ZIP 28625
  • Phone: (704) 873-4484

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NPI Details

GREENBRIAR PRIMARY CARE, PA is a family nurse practitioner in Statesville, NC. GREENBRIAR PRIMARY CARE, PA NPI is 1477789147. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

308-C MOCKSVILLE HIGHWAY
STATESVILLE, NC
ZIP 28625
Phone: (704) 873-4484
Fax: (704) 873-4485

The provider's authorized official is Judy L Keighron .
The authorized official title is President and has the following contact phone number (704) 873-4484.

The CLIA number assigned to this NPI record is 34D1100790 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2009 and was last updated on 8/21/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily201255NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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