Healthcare Provider Details

I. General information

NPI: 1013550698
Provider Name (Legal Business Name): BRITTANY NICHOLE SWEENEY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY NICHOLE HART PA

II. Dates (important events)

Enumeration Date: 10/25/2019
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4729A HOEN AVE
SANTA ROSA CA
95405-7862
US

IV. Provider business mailing address

1657 ANDOVER WAY
PETALUMA CA
94954-7453
US

V. Phone/Fax

Practice location:
  • Phone: 707-577-7800
  • Fax: 707-573-5360
Mailing address:
  • Phone: 406-439-0567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: