Healthcare Provider Details

I. General information

NPI: 1598682650
Provider Name (Legal Business Name): BRITTANY LEA LADNIER CST/CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

597 BIG FOUR RD
WIGGINS MS
39577-9754
US

IV. Provider business mailing address

597 BIG FOUR RD
WIGGINS MS
39577-9754
US

V. Phone/Fax

Practice location:
  • Phone: 601-528-2491
  • Fax:
Mailing address:
  • Phone: 601-528-2491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number214538
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: