Healthcare Provider Details

I. General information

NPI: 1942506340
Provider Name (Legal Business Name): BRITTANY NICHOLE MASSIE STNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2011
Last Update Date: 02/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3165 WASHINGTON WATERLOO RD NE
WASHINGTON COURT HOUSE OH
43160-9072
US

IV. Provider business mailing address

3165 WASHINGTON WATERLOO RD NE
WASHINGTON COURT HOUSE OH
43160-9072
US

V. Phone/Fax

Practice location:
  • Phone: 406-450-3799
  • Fax:
Mailing address:
  • Phone: 406-450-3799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number322692140310
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: