Healthcare Provider Details

I. General information

NPI: 1174172985
Provider Name (Legal Business Name): BRITTANY CHRISTINE MCDONALD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 AVENUE B
SCOTTSBLUFF NE
69361-4303
US

IV. Provider business mailing address

3605 SARATOGA ST
CHEYENNE WY
82001-8546
US

V. Phone/Fax

Practice location:
  • Phone: 308-630-0800
  • Fax:
Mailing address:
  • Phone: 402-366-6817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number112926
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: