Healthcare Provider Details

I. General information

NPI: 1821676172
Provider Name (Legal Business Name): BRITTANY LYNN MYERS RN, ACCNS-AG, PCCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 S LAFOUNTAIN ST
KOKOMO IN
46902-3803
US

IV. Provider business mailing address

3500 S LAFOUNTAIN ST
KOKOMO IN
46902-3803
US

V. Phone/Fax

Practice location:
  • Phone: 765-776-8530
  • Fax:
Mailing address:
  • Phone: 765-776-8530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number28201571A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number28201571A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number28201571A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: