Healthcare Provider Details

I. General information

NPI: 1689161226
Provider Name (Legal Business Name): BRITTANY CHARLTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2018
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2479 E 64TH ST APT 5
CLEVELAND OH
44104-1747
US

IV. Provider business mailing address

16010 PYTHIAS AVE
CLEVELAND OH
44110-1463
US

V. Phone/Fax

Practice location:
  • Phone: 216-303-0432
  • Fax:
Mailing address:
  • Phone: 216-303-0432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.505662
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN.152316
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: