Healthcare Provider Details

I. General information

NPI: 1376487306
Provider Name (Legal Business Name): BRITTANY GORE-YATES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2904 COPPER RIDGE CV N
BARTLETT TN
38134-8542
US

IV. Provider business mailing address

7884 SILVER LAKE LN APT 201
MEMPHIS TN
38119-4559
US

V. Phone/Fax

Practice location:
  • Phone: 901-413-1247
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number4324
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: