Provider Demographics
NPI:1346799038
Name:CICALA, BRITTANY
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:CICALA
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 1:45 OLD SOLOMONS ISLAND RD STE 205
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3800
Mailing Address - Country:US
Mailing Address - Phone:410-224-4348
Mailing Address - Fax:410-224-4732
Practice Address - Street 1:45 OLD SOLOMONS ISLAND RD STE 205
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3800
Practice Address - Country:US
Practice Address - Phone:410-224-4348
Practice Address - Fax:410-224-4732
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR204560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCX59-0005OtherCAREFIRST