Healthcare Provider Details

I. General information

NPI: 1285542613
Provider Name (Legal Business Name): BRITTANY TIARA THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14283 FIREBIRD DR
JACKSONVILLE FL
32234-2515
US

IV. Provider business mailing address

14283 FIREBIRD DR
JACKSONVILLE FL
32234-2515
US

V. Phone/Fax

Practice location:
  • Phone: 904-888-2731
  • Fax:
Mailing address:
  • Phone: 904-888-2731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN9603460
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: