Provider Demographics
NPI:1093452583
Name:WAISNER, BRITTNEY KAYE
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:KAYE
Last Name:WAISNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 LEORA LN APT 523
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4627
Mailing Address - Country:US
Mailing Address - Phone:469-744-1782
Mailing Address - Fax:
Practice Address - Street 1:3535 VICTORY GROUP WAY STE 305
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6722
Practice Address - Country:US
Practice Address - Phone:972-324-3480
Practice Address - Fax:877-637-1611
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078220208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics