Provider Demographics
NPI:1437652807
Name:GEDITZ, BRITTANY ROSE (PA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ROSE
Last Name:GEDITZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:1903 S 6TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-4599
Mailing Address - Country:US
Mailing Address - Phone:218-454-3376
Mailing Address - Fax:218-454-4263
Practice Address - Street 1:415 BARCLAY AVE
Practice Address - Street 2:
Practice Address - City:PINE RIVER
Practice Address - State:MN
Practice Address - Zip Code:56474-5139
Practice Address - Country:US
Practice Address - Phone:218-454-3376
Practice Address - Fax:218-454-4263
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2022-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN12666363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical