Healthcare Provider Details

I. General information

NPI: 1285578419
Provider Name (Legal Business Name): BRITTNEY L MARTIN CPSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 HIGHWAY 80 W
JACKSON MS
39209-7201
US

IV. Provider business mailing address

2240 TV RD APT 5C
JACKSON MS
39209-3587
US

V. Phone/Fax

Practice location:
  • Phone: 601-910-8810
  • Fax:
Mailing address:
  • Phone: 601-910-8810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number686
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: