Healthcare Provider Details

I. General information

NPI: 1750999694
Provider Name (Legal Business Name): BRITTNEY IBBITSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 PAGE TERRACE
HINCKLEY ME
04944
US

IV. Provider business mailing address

PO BOX 159
HINCKLEY ME
04944-0159
US

V. Phone/Fax

Practice location:
  • Phone: 207-660-5963
  • Fax:
Mailing address:
  • Phone: 207-509-0182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN71309
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License NumberRN71309
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN71309
License Number StateME
# 4
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN71309
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: