=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376219675
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTNY BRIANT AGACNP-BC, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2021
-----------------------------------------------------
Last Update Date | 08/18/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2002 HOLCOMBE BLVD
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-4211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-791-1414
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13227 CHESTNUT FIELD CT
-----------------------------------------------------
City | ROSHARON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77583-0378
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-319-5399
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | AP141891
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------