Provider Demographics
NPI:1114454816
Name:AYERS, BRITTNEY RENA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:RENA
Last Name:AYERS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4514 LUBBOCK DR APT B
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-1773
Mailing Address - Country:US
Mailing Address - Phone:805-433-4379
Mailing Address - Fax:
Practice Address - Street 1:1147 RED TAIL WAY
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-7232
Practice Address - Country:US
Practice Address - Phone:805-527-8055
Practice Address - Fax:805-520-8849
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95113655163W00000X
CAVN279709164W00000X
CA95014234363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse