Provider Demographics
NPI:1396981429
Name:BRISSON, DAWN LEANNETTE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:LEANNETTE
Last Name:BRISSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DAWN
Other - Middle Name:LEANNETTE
Other - Last Name:BRISSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2344 H BULLARD RD
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-7932
Mailing Address - Country:US
Mailing Address - Phone:910-876-0561
Mailing Address - Fax:
Practice Address - Street 1:2344 H BULLARD RD
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-7932
Practice Address - Country:US
Practice Address - Phone:910-876-0561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0265652Medicaid
NC0266477Medicaid
NC6444130001Medicare NSC
NC0421580001Medicare NSC