Provider Demographics
NPI:1225718968
Name:BURGY, BRITTANY DEANN (APRN, CNM)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:DEANN
Last Name:BURGY
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:DEANN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:407 BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-2625
Mailing Address - Country:US
Mailing Address - Phone:734-972-3101
Mailing Address - Fax:
Practice Address - Street 1:6050 STERLING CREEK RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-7752
Practice Address - Country:US
Practice Address - Phone:219-763-8112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09000435A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife