Provider Demographics
NPI:1528646130
Name:BROSNAN, BARBARA (NBC-HWC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BROSNAN
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8015 WADE GREEN PL
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-1516
Mailing Address - Country:US
Mailing Address - Phone:919-590-0405
Mailing Address - Fax:
Practice Address - Street 1:8015 WADE GREEN PL
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-1516
Practice Address - Country:US
Practice Address - Phone:919-590-0405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-3177280171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach