Brino, Kassondra Amada Shoemaker

Brino, Kassondra Amada Shoemaker is an individual health care provider with primary practice located at 307 S Salem St Ste 100 , Apex NC 27502-1845. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Brino, Kassondra Amada Shoemaker can be contacted via phone (919) 627-8771.

Contact Information

Primary practice address
307 S Salem St Ste 100 Apex NC 27502-1845
Phone: (919) 627-8771
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X 5010693 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 5010693 North Carolina

Profile Details

NPI number 1548746365
LBN Legal business name Brino, Kassondra Amada Shoemaker
Credentials RN, CPNP-PC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2018
Last updated Oct 28th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548746365 NPPES
North Carolina MEDICAID 68535

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