Healthcare Provider Details

I. General information

NPI: 1720552268
Provider Name (Legal Business Name): BRITTANY CARNEY GARDNER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY KAYE CARNEY FNP-C

II. Dates (important events)

Enumeration Date: 01/17/2019
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MAIN ST
QUITMAN MS
39355-2119
US

IV. Provider business mailing address

111 MAIN ST
QUITMAN MS
39355-2119
US

V. Phone/Fax

Practice location:
  • Phone: 601-557-5105
  • Fax: 601-557-5106
Mailing address:
  • Phone: 601-557-5105
  • Fax: 601-557-5106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number903051
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: