Healthcare Provider Details

I. General information

NPI: 1578151833
Provider Name (Legal Business Name): BRITTANY LYNN DAVAULT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2021
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 E JACKRABBIT RD
SCOTTSDALE AZ
85250-6730
US

IV. Provider business mailing address

8500 E JACKRABBIT RD
SCOTTSDALE AZ
85250-6730
US

V. Phone/Fax

Practice location:
  • Phone: 480-484-5073
  • Fax:
Mailing address:
  • Phone: 480-484-5073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN213327
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: