Healthcare Provider Details

I. General information

NPI: 1881464097
Provider Name (Legal Business Name): BRITTANY ANDREA BROWN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY ANDREA FERGUSON RN

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 MAGNOLIA LN APT 4406
DAYTON OH
45440-1484
US

IV. Provider business mailing address

57 MAGNOLIA LN APT 4406
DAYTON OH
45440-1484
US

V. Phone/Fax

Practice location:
  • Phone: 317-363-3103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number28246741A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: