Provider Demographics
NPI:1194433052
Name:BRIX, TATIANA (DNP)
Entity type:Individual
Prefix:DR
First Name:TATIANA
Middle Name:
Last Name:BRIX
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 EXPRESS DR
Mailing Address - Street 2:
Mailing Address - City:SHALLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28470-6501
Mailing Address - Country:US
Mailing Address - Phone:910-754-2229
Mailing Address - Fax:
Practice Address - Street 1:3650 EXPRESS DR
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-6501
Practice Address - Country:US
Practice Address - Phone:910-754-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC202223747363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner