Healthcare Provider Details

I. General information

NPI: 1073018263
Provider Name (Legal Business Name): BRITTANY ANN RICHARDSON DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY ANN DAVIS BRITTANY ANN DAVIS

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 LACEY ST
CAPE GIRARDEAU MO
63701
US

IV. Provider business mailing address

9750 EVERGREEN LN
BLOOMSDALE MO
63627-8963
US

V. Phone/Fax

Practice location:
  • Phone: 573-334-4822
  • Fax:
Mailing address:
  • Phone: 618-218-8071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2018020908
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: