Provider Demographics
NPI:1013550698
Name:SWEENEY, BRITTANY NICHOLE (PA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICHOLE
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:NICHOLE
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1657 ANDOVER WAY
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-7453
Mailing Address - Country:US
Mailing Address - Phone:406-439-0567
Mailing Address - Fax:
Practice Address - Street 1:4729A HOEN AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-7862
Practice Address - Country:US
Practice Address - Phone:707-577-7800
Practice Address - Fax:707-573-5360
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant