Dakota Griffin Brunswick, PA
Physician Assistant in Concord, NC. Individual provider (NPI-1).
NPI number1275124596
StatusActive
Last updated in NPPESApr 25, 2024
Details
- NPI
- 1275124596
- Entity type
- Individual (NPI-1)
- Name
- Dakota Griffin Brunswick
- Credential
- PA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 29, 2021
- Certification date
- Apr 25, 2024
- Last updated
- Apr 25, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 1010856 | NC | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – |
Practice location
280 Executive Park Dr Ste 100Concord, NC 28025-1838
Phone 237-424-0704
Mailing address
3808 Riverbend RdCharlotte, NC 28210-6822
Phone 336-905-0685
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