Healthcare Provider Details

I. General information

NPI: 1023866357
Provider Name (Legal Business Name): BREANNA JEWELL BRITTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 HIGH ST
OOLTEWAH TN
37363-9007
US

IV. Provider business mailing address

2233 N FORK DR
SODDY DAISY TN
37379-3465
US

V. Phone/Fax

Practice location:
  • Phone: 423-209-6020
  • Fax:
Mailing address:
  • Phone: 423-802-8506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number268248
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: