Provider Demographics
NPI:1043578271
Name:BRITTAIN, SONIA JOLENE (RN)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:JOLENE
Last Name:BRITTAIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34560 GAROUTTE RD
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-8537
Mailing Address - Country:US
Mailing Address - Phone:541-554-6333
Mailing Address - Fax:186-626-4686
Practice Address - Street 1:34560 GAROUTTE RD
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-8537
Practice Address - Country:US
Practice Address - Phone:541-554-6333
Practice Address - Fax:186-626-4686
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR097000418RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health