Provider Demographics
NPI:1083485858
Name:GRIMM-WASH, BRITTNEY SIERRA (NP)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:SIERRA
Last Name:GRIMM-WASH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:SIERRA
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2970 CALDWELL RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-5888
Mailing Address - Country:US
Mailing Address - Phone:314-662-4926
Mailing Address - Fax:
Practice Address - Street 1:101 CABARRUS AVE E STE 200
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-3781
Practice Address - Country:US
Practice Address - Phone:855-743-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019409363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily