Provider Demographics
NPI:1043754815
Name:DAVIDSON, BRITTANY (APRN)
Entity Type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 NEW HARTFORD RD. SUITE A
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303
Mailing Address - Country:US
Mailing Address - Phone:270-922-2500
Mailing Address - Fax:270-922-2505
Practice Address - Street 1:2851 NEW HARTFORD RD. SUITE A
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303
Practice Address - Country:US
Practice Address - Phone:270-922-2500
Practice Address - Fax:270-922-2505
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100436850Medicaid