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Charles Bradley Quillen

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

189 Hospital Dr, Spruce Pine, NC 28777-3035

PECOS Enrollment

This provider is enrolled in PECOS as CHARLES QUILLEN.

Based on the most recent information from CMS, provider Charles Bradley Quillen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1093248718
Provider Type
Individual
Full Name
Quillen, Charles Bradley
Title
Dr.
Credential
DNP

Gender
Male
Sole Proprietor
No
Enumeration Date
4/10/2017
Last Updated
1/27/2022

Contact Information

Practice Location

189 Hospital Dr, Spruce Pine, NC 28777-3035

(828) 213-4444

Unlisted Fax

Mailing Location

50 Schenck Pkwy, Asheville, NC 28803-3499

(828) 651-6576

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 291932 North Carolina
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 291932 North Carolina

Charles Bradley Quillen

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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