Healthcare Provider Details

I. General information

NPI: 1942964705
Provider Name (Legal Business Name): BRITTNEY ANNE SHULTS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 N MILITARY ST
LORETTO TN
38469-2336
US

IV. Provider business mailing address

9 FRANKLIN DR
LAWRENCEBURG TN
38464-4526
US

V. Phone/Fax

Practice location:
  • Phone: 931-853-4622
  • Fax:
Mailing address:
  • Phone: 931-231-0967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number29336
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: