Healthcare Provider Details

I. General information

NPI: 1942850698
Provider Name (Legal Business Name): BRITTANY RENEE STAMM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2019
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4635 BARCHETTA DR
LAND O LAKES FL
34639-9593
US

IV. Provider business mailing address

4635 BARCHETTA DR
LAND O LAKES FL
34639-9593
US

V. Phone/Fax

Practice location:
  • Phone: 901-830-5821
  • Fax:
Mailing address:
  • Phone: 901-830-5821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: