Healthcare Provider Details

I. General information

NPI: 1700632445
Provider Name (Legal Business Name): BRITTNEY RENEE SMITH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2064 FAIRPORT NINE MILE POINT RD
PENFIELD NY
14526-1750
US

IV. Provider business mailing address

601 ELMWOOD AVENUE BOX 665
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-5321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number352832
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: