Healthcare Provider Details

I. General information

NPI: 1851103774
Provider Name (Legal Business Name): BRITTANY JOHNSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 SUNNYVIEW LN STE 5
KALISPELL MT
59901-3128
US

IV. Provider business mailing address

210 SUNNYVIEW LN STE 5
KALISPELL MT
59901-3128
US

V. Phone/Fax

Practice location:
  • Phone: 406-253-4071
  • Fax:
Mailing address:
  • Phone: 406-253-4071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number37370
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: