Provider Demographics
NPI:1235792367
Name:BRITTAIN, NEVIN
Entity Type:Individual
Prefix:
First Name:NEVIN
Middle Name:
Last Name:BRITTAIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2843 E GRAND RIVER AVE STE 272
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6724
Mailing Address - Country:US
Mailing Address - Phone:517-703-4610
Mailing Address - Fax:
Practice Address - Street 1:2092 LAC DU MONT APT D-T
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-9564
Practice Address - Country:US
Practice Address - Phone:517-703-4610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital