MEDICARE: MS. BRITTANY NICOLE LAIN ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	11033461	FL

General Provider Information

NPI Number	:	1295578896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRITTANY NICOLE LAIN ARNP

Provider Business Mailing Address
First Line	:	2802 SE LEIGH AVE
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-7345
Country	:	US
Telephone Number	:	772-380-2642
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 SE HILLMOOR DR STE 7
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-7552
Country	:	US
Telephone Number	:	772-480-0560
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2024
Last Update Date	:	06/16/2026

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