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General NPI Number Information
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NPI Number | 1982160065
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Entity Type | Individual
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Provider Name | BRITTANY ANN HOMAN PA
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Gender | Female
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 800 W MAIN ST
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City | COLDWATER
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State | OH
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Zip | 45828-1613
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Country | US
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Telephone | 260-344-4035
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Fax |
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Provider Business Mailing Address
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Address Line | 6435 W JEFFERSON BLVD PMB 109
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City | FORT WAYNE
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State | IN
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Zip | 46804-6203
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Country | US
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Telephone | 260-344-4035
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Fax | 260-969-9272
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.005955RX
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License Number State | OH
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