Provider Demographics
NPI:1073871786
Name:CARLSON, BRITTNEY JANE (RN)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:JANE
Last Name:CARLSON
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 1:356 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLANDING
Mailing Address - State:UT
Mailing Address - Zip Code:84511-3830
Mailing Address - Country:US
Mailing Address - Phone:435-678-2992
Mailing Address - Fax:435-678-3116
Practice Address - Street 1:356 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BLANDING
Practice Address - State:UT
Practice Address - Zip Code:84511-3830
Practice Address - Country:US
Practice Address - Phone:435-678-2992
Practice Address - Fax:435-678-3116
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7349870-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse