Healthcare Provider Details

I. General information

NPI: 1962753368
Provider Name (Legal Business Name): BRITTNEY RENEE DAVIS C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 10/19/2020
Certification Date: 10/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 CARRAWAY DR SUITE A
WINFIELD AL
35594-5067
US

IV. Provider business mailing address

191 CARRAWAY DR SUITE A
WINFIELD AL
35594-5067
US

V. Phone/Fax

Practice location:
  • Phone: 205-487-1586
  • Fax: 205-487-1589
Mailing address:
  • Phone: 205-487-1586
  • Fax: 205-487-1589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-113600
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1-113600
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: