Provider Demographics
NPI:1295025955
Name:DEETER, BRITTANY MARIE
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:MARIE
Last Name:DEETER
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 1:769 STEVENS RD
Mailing Address - Street 2:
Mailing Address - City:COCHRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:16314-1737
Mailing Address - Country:US
Mailing Address - Phone:814-758-8139
Mailing Address - Fax:
Practice Address - Street 1:401 W SPRING ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-2169
Practice Address - Country:US
Practice Address - Phone:814-827-5719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist