Healthcare Provider Details

I. General information

NPI: 1619857711
Provider Name (Legal Business Name): BRITTANY YEARWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6944 HIGHWAY 85
RIVERDALE GA
30274-2954
US

IV. Provider business mailing address

135 GREENFIELD WAY
COVINGTON GA
30016-1149
US

V. Phone/Fax

Practice location:
  • Phone: 770-683-6946
  • Fax:
Mailing address:
  • Phone: 404-429-3565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN184093
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: