Provider Demographics
NPI:1699438309
Name:BRUNSON, SHAREEKA LATEEA (NP)
Entity type:Individual
Prefix:MS
First Name:SHAREEKA
Middle Name:LATEEA
Last Name:BRUNSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2817 ROCK MERRITT AVENUE
Mailing Address - Street 2:
Mailing Address - City:FORT LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:910-907-8500
Mailing Address - Fax:910-907-9468
Practice Address - Street 1:2817 ROCK MERRITT AVENUE
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-8500
Practice Address - Fax:910-907-9468
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015242363LF0000X
NCBRUN-9TU43363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily