Provider Demographics
NPI:1124790985
Name:BRAME, HANNAH GILBERT (PA-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:GILBERT
Last Name:BRAME
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MARIE
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:864 BLACK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FOUR OAKS
Mailing Address - State:NC
Mailing Address - Zip Code:27524-8314
Mailing Address - Country:US
Mailing Address - Phone:919-963-3148
Mailing Address - Fax:919-963-2900
Practice Address - Street 1:864 BLACK CREEK RD
Practice Address - Street 2:
Practice Address - City:FOUR OAKS
Practice Address - State:NC
Practice Address - Zip Code:27524-8314
Practice Address - Country:US
Practice Address - Phone:919-963-3148
Practice Address - Fax:919-963-2900
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-12050363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty