Healthcare Provider Details

I. General information

NPI: 1225425119
Provider Name (Legal Business Name): MRS. BRITTANY STOKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY GIMBEL

II. Dates (important events)

Enumeration Date: 04/19/2015
Last Update Date: 06/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 TENNESSEE ST APT. D
REDLANDS CA
92373-4492
US

IV. Provider business mailing address

97 TENNESSEE ST APT. D
REDLANDS CA
92373-4492
US

V. Phone/Fax

Practice location:
  • Phone: 423-871-3111
  • Fax:
Mailing address:
  • Phone: 423-871-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95000315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: