Provider Demographics
NPI:1174267264
Name:HARRIS, BRITTANY JOI (CSN)
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:JOI
Last Name:HARRIS
Suffix:
Gender:F
Credentials:CSN
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:JOI
Other - Last Name:HADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSN
Mailing Address - Street 1:1250 VILLA RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6587
Mailing Address - Country:US
Mailing Address - Phone:404-984-1019
Mailing Address - Fax:
Practice Address - Street 1:1250 VILLA RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6587
Practice Address - Country:US
Practice Address - Phone:404-984-1019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No171400000XOther Service ProvidersHealth & Wellness Coach
No174200000XOther Service ProvidersMeals
No376K00000XNursing Service Related ProvidersNurse's Aide