Provider Demographics
NPI:1467875211
Name:DERBIGNY, BRITTANI
Entity Type:Individual
Prefix:
First Name:BRITTANI
Middle Name:
Last Name:DERBIGNY
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 1:15770 BELLAIRE BLVD APT 305
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-3004
Mailing Address - Country:US
Mailing Address - Phone:832-378-4264
Mailing Address - Fax:
Practice Address - Street 1:3008 BLODGETT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5304
Practice Address - Country:US
Practice Address - Phone:281-501-0551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313351164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse