Healthcare Provider Details

I. General information

NPI: 1144130519
Provider Name (Legal Business Name): BRITTNEY SUE POWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 BROADWAY ST STE 101
BARABOO WI
53913-2488
US

IV. Provider business mailing address

3505 8TH AVE
WISCONSIN DELLS WI
53965-8988
US

V. Phone/Fax

Practice location:
  • Phone: 608-355-4103
  • Fax:
Mailing address:
  • Phone: 608-697-6945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: