Healthcare Provider Details

I. General information

NPI: 1225693294
Provider Name (Legal Business Name): BRITTANY YOUNG BAKER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2019
Last Update Date: 05/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 VALLEY RIDGE RD
COVINGTON VA
24426-6339
US

IV. Provider business mailing address

821 ONEIDA TRL
COVINGTON VA
24426-6919
US

V. Phone/Fax

Practice location:
  • Phone: 540-862-4146
  • Fax:
Mailing address:
  • Phone: 540-969-8187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024177566
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: