Provider Demographics
NPI:1477106037
Name:HUDLET, BRITTNI (PEER SPECIALIST)
Entity Type:Individual
Prefix:
First Name:BRITTNI
Middle Name:
Last Name:HUDLET
Suffix:
Gender:F
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1387
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-1387
Mailing Address - Country:US
Mailing Address - Phone:208-415-0299
Mailing Address - Fax:
Practice Address - Street 1:2205 N IRONWOOD PL STE 100
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2487
Practice Address - Country:US
Practice Address - Phone:208-415-0299
Practice Address - Fax:208-625-2070
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDZF392376FOtherDRIVERS LICENSE