Healthcare Provider Details

I. General information

NPI: 1689587347
Provider Name (Legal Business Name): BRITTANY ELY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 N COUNTY ROAD 275 E
LOGANSPORT IN
46947-8070
US

IV. Provider business mailing address

2350 N COUNTY ROAD 275 E
LOGANSPORT IN
46947-8070
US

V. Phone/Fax

Practice location:
  • Phone: 574-721-8235
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28187306C
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: