Healthcare Provider Details

I. General information

NPI: 1760217566
Provider Name (Legal Business Name): BRITTANY NICOLE ALLBRITTON RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 09/03/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 AVENT DR
GRENADA MS
38901-5230
US

IV. Provider business mailing address

730 N MISSION RD
WINONA MS
38967-9537
US

V. Phone/Fax

Practice location:
  • Phone: 662-227-7122
  • Fax:
Mailing address:
  • Phone: 662-809-6878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number906852
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: