Healthcare Provider Details

I. General information

NPI: 1922157981
Provider Name (Legal Business Name): HORTENSE REDD BRITT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-5800
US

IV. Provider business mailing address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-5800
US

V. Phone/Fax

Practice location:
  • Phone: 301-677-8131
  • Fax:
Mailing address:
  • Phone: 301-677-8131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number79988
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: