=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629612882
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANY HENTOSZ CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2019
-----------------------------------------------------
Last Update Date | 11/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 75 ARCH ST. SUITE 506
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-375-3894
-----------------------------------------------------
Fax | 330-375-6680
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 75 ARCH ST. SUITE 506
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-253-9727
-----------------------------------------------------
Fax | 330-926-5866
-----------------------------------------------------
=====================================================
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 | F09190241
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.025593
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------