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NPI Code Detail

MEDICARE: BRITTANI HORNSTRA

MEDICARE: BRITTANI HORNSTRA
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
12255A2300XAthletic TrainerATR-009522AZ

General Provider Information

NPI Number : 1992462246
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANI HORNSTRA
Provider Business Mailing Address
First Line : 1653 S HARRIS DR APT 1006
Second Line :
City : MESA
State : AZ
Zip : 85204-6718
Country : US
Telephone Number : 360-594-7258
Fax Number :
Provider Business Practice Location Address
First Line : 2076 S HIGLEY RD
Second Line :
City : GILBERT
State : AZ
Zip : 85295-4793
Country : US
Telephone Number : 480-279-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2021
Last Update Date : 09/27/2023

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Directions to “ BRITTANI HORNSTRA ” Practice Location

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