Healthcare Provider Details

I. General information

NPI: 1205338266
Provider Name (Legal Business Name): BRITTANY FAITH REKKAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. BRITTANY FAITH GODWIN

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 05/17/2022
Certification Date: 05/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12271 US HIGHWAY 301 N
PARRISH FL
34219
US

IV. Provider business mailing address

101 RIVERFRONT BLVD. SUITE 710
BRADENTON FL
34205
US

V. Phone/Fax

Practice location:
  • Phone: 941-776-4050
  • Fax: 941-776-4057
Mailing address:
  • Phone: 941-209-0610
  • Fax: 941-776-4057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9372074
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: