Healthcare Provider Details

I. General information

NPI: 1194632851
Provider Name (Legal Business Name): BRITTANY NELSON
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4881 SUGAR MAPLE DR BLDG 830
DAYTON OH
45433-5529
US

IV. Provider business mailing address

1219 ARTESIAN LN
FAIRBORN OH
45324-3789
US

V. Phone/Fax

Practice location:
  • Phone: 937-257-1160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number242202
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: