Healthcare Provider Details

I. General information

NPI: 1275920803
Provider Name (Legal Business Name): BRITTANY BURTSFIELD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HIGH PARK AVE
GOSHEN IN
46526-4810
US

IV. Provider business mailing address

200 HIGH PARK AVE
GOSHEN IN
46526-4810
US

V. Phone/Fax

Practice location:
  • Phone: 574-364-2608
  • Fax: 574-364-2783
Mailing address:
  • Phone: 574-364-2608
  • Fax: 574-364-2783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71005420B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: