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NPI Code Detail

MEDICARE: BRITTANY EMILY BODKIN

MEDICARE: BRITTANY EMILY BODKIN
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
1363LF0000XFamily Nurse PractitionerAP142687TX

General Provider Information

NPI Number : 1902452337
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY EMILY BODKIN
Provider Business Mailing Address
First Line : 1615 W CHURCH ST STE 100A
Second Line :
City : LIVINGSTON
State : TX
Zip : 77351-9004
Country : US
Telephone Number : 936-286-4767
Fax Number :
Provider Business Practice Location Address
First Line : 2236 N LOOP 336 W
Second Line :
City : CONROE
State : TX
Zip : 77304-3519
Country : US
Telephone Number : 936-441-2003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2019
Last Update Date : 11/20/2024

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Directions to “ BRITTANY EMILY BODKIN ” Practice Location

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