MEDICARE: MRS. BRITTANY STRONG NP

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	363LF0000X	Family Nurse Practitioner	4924665-4405	UT

General Provider Information

NPI Number	:	1427300649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRITTANY STRONG NP

Provider Business Mailing Address
First Line	:	PO BOX 208
Second Line	:
City	:	BLOOMINGTON
State	:	ID
Zip	:	83223
Country	:	US
Telephone Number	:	801-362-0157
Fax Number	:

Provider Business Practice Location Address
First Line	:	396 YELLOWSTONE AVE
Second Line	:
City	:	POCATELLO
State	:	ID
Zip	:	83201-4572
Country	:	US
Telephone Number	:	208-497-8672
Fax Number	:

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

Provider Enumeration Date	:	10/11/2012
Last Update Date	:	07/21/2022

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