Healthcare Provider Details

I. General information

NPI: 1437054731
Provider Name (Legal Business Name): BRITNEY NICOLE KIRTLAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38930 N CHICAGO AVE
WADSWORTH IL
60083-9451
US

IV. Provider business mailing address

38930 N CHICAGO AVE
WADSWORTH IL
60083-9451
US

V. Phone/Fax

Practice location:
  • Phone: 478-542-4928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number1128098-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: