MEDICARE: BRITTANY FAISON RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	127066	CT

General Provider Information

NPI Number	:	1033854724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY FAISON RN

Provider Business Mailing Address
First Line	:	PO BOX 26350
Second Line	:
City	:	WEST HAVEN
State	:	CT
Zip	:	06516-0963
Country	:	US
Telephone Number	:	202-997-2727
Fax Number	:

Provider Business Practice Location Address
First Line	:	149 CANTON ST UNIT 28
Second Line	:
City	:	WEST HAVEN
State	:	CT
Zip	:	06516-2236
Country	:	US
Telephone Number	:	203-491-6118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2022
Last Update Date	:	04/28/2022

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