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NPI Code Detail

MEDICARE: BRITTANY NICOLE DILLARD

MEDICARE: BRITTANY NICOLE DILLARD
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
11835P2201XAmbulatory Care Pharmacist5302042557MI

General Provider Information

NPI Number : 1992295190
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY NICOLE DILLARD
Provider Business Mailing Address
First Line : 665 SEWARD AVE NW STE 320
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49504-5190
Country : US
Telephone Number : 616-267-7029
Fax Number :
Provider Business Practice Location Address
First Line : 4600 BRETON RD SE STE 102
Second Line :
City : KENTWOOD
State : MI
Zip : 49508-5220
Country : US
Telephone Number : 616-391-9705
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2018
Last Update Date : 05/14/2018

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Directions to “ BRITTANY NICOLE DILLARD ” Practice Location

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