BREANNA MARIE GORE (NPI# 1740753383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740753383 |
| Entity Type | Individual |
| Full Name | BREANNA MARIE GORE |
| Credential | PA-C |
| Practice Address |
1327 Robeson St Fayetteville NC 28305-5531 |
| Mailing Address |
5505 White Oak Dr Lumberton NC 28358-1130 |
| Practice Telephone | 9104865437 |
| Mailing Telephone | 9107343462 |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2019-01-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 001008708 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003350570 | Breanna N Gore | Technician, Other | 2080 Whittaker Rd # 164, Ypsilanti, MI 48197-8238 | 2016-12-18 |
| Street Address |
1327 ROBESON ST |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28305-5531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184621112 | Dejie John | Pediatrics | 1327 Robeson St, Fayetteville, NC 28305-5531 | 2005-07-06 |
| 1235605379 | Lindsey Lee Mulholland | Lactation Consultant, Non-RN | 1327 Robeson St, Fayetteville, NC 28305-5531 | 2018-10-16 |
| 1871017483 | Kelli Canady | Registered Nurse | 1327 Robeson St, Fayetteville, NC 28305-5531 | 2017-07-26 |
| 1689030835 | Donna B Parker | Nurse Practitioner | 1327 Robeson St, Fayetteville, NC 28305-5531 | 2016-01-04 |
| 1699148445 | Rainbow Pediatrics | Nurse Practitioner | 1327 Robeson St, Fayetteville, NC 28305-5531 | 2015-11-02 |
| 1407142466 | Esther Nissao | Pediatrics | 1327 Robeson St, Fayetteville, NC 28305-5531 | 2011-06-28 |
| 1598085631 | Jocelyn Fairashta Mason | Pediatrics | 1327 Robeson St, Fayetteville, NC 28305-5531 | 2010-06-10 |
| 1255575056 | Ashley Ellsworth Call | Pediatrics | 1327 Robeson St, Fayetteville, NC 28305-5531 | 2009-04-23 |
| 1649431578 | Mariya L Koval | Pediatrics | 1327 Robeson St, Fayetteville, NC 28305-5531 | 2008-06-23 |
| 1164612610 | Cinthia Edwards Follrod | Clinical Nurse Specialist | 1327 Robeson St, Fayetteville, NC 28305-5531 | 2007-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437637733 | Shannon S Wiggins | Social Worker | 2525 Raeford Rd Ste A, Fayetteville, NC 28305 | 2018-07-30 |
| 1205345790 | Sarah Elizabeth Hudson | Marriage & Family Therapist | 214 Fairway Dr, Fayetteville, NC 28305 | 2017-09-27 |
| 1336533116 | Avalon Counseling Services Pa | Counselor | 916 B Arsenal Ave, Fayetteville, NC 28305 | 2015-03-19 |
| 1568882827 | Kenneth Brown | Counselor | 901 Arsenal Avenue, Suite, Fayetteville, NC 28305 | 2014-04-24 |
| 1174879423 | Lynette Maxwell Pierce | Dentist | 2537-b Raeford Rd, Fayetteville, NC 28305 | 2012-07-24 |
| 1356640973 | Charlene Jones | Social Worker | 560 Lambert St, Fayetteville, NC 28305 | 2011-03-22 |
| 1659518173 | Christine R Campbell | Speech-Language Pathologist | 2401 Roberson Street, Fayettville, NC 28305 | 2009-01-21 |
| 1588814628 | Zakiya S Karim | Pediatrics | 1327 Robeson Street, Fayetteville, NC 28305 | 2008-09-25 |
| 1710134770 | Bright Heart Healthcare Staffing | Nursing Care | 2504 Rareford Rd, Fayetteville, NC 28305 | 2008-08-21 |
| 1730272402 | Dale A Childers | Dentist | 2409 Robeson Street, Fayetteville, NC 28305 | 2006-10-02 |
| Find all providers in zip 28305 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443387 | Melissa Macneil Spencer | Physician Assistant | 810 Knighthood Cir, Fayetteville, NY 13066-8721 | 2020-10-03 |
| 1366067548 | Prathna Raval | Physician Assistant | 6808 Thames Dr, Fayetteville, NC 28306-2524 | 2020-06-12 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1144858515 | Mackenzie Anna Kirchner | Physician Assistant | 568 Sandy Creek Rd, Fayetteville, GA 30214-4205 | 2020-03-31 |
| 1770116931 | Chasity Nicole Sullivan | Physician Assistant | 202b Highland Ave, Fayetteville, NC 28305-5308 | 2020-02-17 |
| 1740812833 | Madeline Everitt Monday | Physician Assistant | 705 Stonington Dr, Fayetteville, NC 28311-0329 | 2020-02-07 |
| 1396375325 | Lisa Ann Gross | Physician Assistant | 3007 Town Center Dr Ste 100, Fayetteville, NC 28306-3663 | 2020-01-17 |
| 1811536048 | Kelly Hamilton Sweatt | Physician Assistant | 1991 Fordham Dr Ste 200, Fayetteville, NC 28304-3774 | 2020-01-06 |
| 1922563667 | Reandy Nicole Hearn | Physician Assistant | 2911 Breezewood Ave Ste 100, Fayetteville, NC 28303-5464 | 2019-02-06 |
| 1790259430 | Cassandra Ann Nebosky-diaz | Physician Assistant | 659 Daharan Dr, Fayetteville, NC 28314-6538 | 2019-01-16 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28305 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.