1437153327 NPI number — ELIZABETH NELSON BRITTON NP

Table of content: ELIZABETH NELSON BRITTON NP (NPI 1437153327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437153327 NPI number — ELIZABETH NELSON BRITTON NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRITTON
Provider First Name:
ELIZABETH
Provider Middle Name:
NELSON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437153327
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1222 KIMBRO DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70808-6046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-769-2790
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5825 AIRLINE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70805-2408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-354-2000
Provider Business Practice Location Address Fax Number:
225-358-4876
Provider Enumeration Date:
06/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  RN050756 APO1861 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1685593 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com