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General NPI Number Information
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NPI Number | 1386424869
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Entity Type | Individual
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Provider Name | BRITTANY CAMILLE
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Gender | Female
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Dates
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Enumeration Date | 10/03/2023
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 110 SERENITY LOOP
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City | LAKE WALES
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State | FL
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Zip | 33859-6816
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Country | US
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Telephone | 863-944-6868
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Fax |
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Provider Business Mailing Address
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Address Line | 110 SERENITY LOOP APT 102
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City | LAKE WALES
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State | FL
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Zip | 33859-6817
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Country | US
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Telephone | 406-403-2549
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | FL
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