Healthcare Provider Details

I. General information

NPI: 1932899853
Provider Name (Legal Business Name): BRITTANY R BRAILSFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY MCLAUGHLIN

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD
DETROIT MI
48202-2608
US

IV. Provider business mailing address

2799 W GRAND BLVD
DETROIT MI
48202-2608
US

V. Phone/Fax

Practice location:
  • Phone: 313-916-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number4704339052
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704339052
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: