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NPI Code Detail

MEDICARE: MR. BRITTANY SIMONE GHOLSTON RN

MEDICARE:  MR. BRITTANY SIMONE GHOLSTON  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
1163WH0200XHome Health Registered Nurse1-192780AL

General Provider Information

NPI Number : 1922680842
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRITTANY SIMONE GHOLSTON RN
Provider Business Mailing Address
First Line : 4212 CARMICHAEL CT N
Second Line :
City : MONTGOMERY
State : AL
Zip : 36106-3621
Country : US
Telephone Number : 334-306-6618
Fax Number : 334-888-8556
Provider Business Practice Location Address
First Line : 4212 CARMICHAEL CT N
Second Line :
City : MONTGOMERY
State : AL
Zip : 36106-3621
Country : US
Telephone Number : 334-306-6618
Fax Number : 334-888-8556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2021
Last Update Date : 03/02/2026

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Directions to “ MR. BRITTANY SIMONE GHOLSTON RN” Practice Location

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