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General NPI Number Information
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NPI Number | 1326860206
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Entity Type | Individual
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Provider Name | BRITTANI CROSS
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Gender | Female
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 7700 2ND AVE
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City | DETROIT
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State | MI
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Zip | 48202-2477
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Country | US
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Telephone | 313-919-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 18030 WILDEMERE ST
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City | DETROIT
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State | MI
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Zip | 48221-2729
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Country | US
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Telephone | 313-953-7203
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 96008474
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License Number State | MI
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