=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609448315
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTNEY OSTRANDER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2021
-----------------------------------------------------
Last Update Date | 07/03/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3801 S KANNER HWY
-----------------------------------------------------
City | STUART
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34994-4801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-223-4999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 107 OCEANSIDE ST
-----------------------------------------------------
City | ISLIP TERRACE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11752-1303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-669-7012
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11015491
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------