Healthcare Provider Details

I. General information

NPI: 1265825392
Provider Name (Legal Business Name): BRITTANY NEWELL BRICKEN CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2015
Last Update Date: 01/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 HIGHWAY 78 E MEDICAL ARTS TOWER, SUITE 110
JASPER AL
35501-8956
US

IV. Provider business mailing address

1130 22ND ST S RIDGE PARK PLACE, SUITE 1000
BIRMINGHAM AL
35205-2870
US

V. Phone/Fax

Practice location:
  • Phone: 205-221-1755
  • Fax: 205-221-9961
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number1-100374
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-100374
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: