Provider Demographics
NPI:1497172779
Name:ROBERTS, BRITTANY LYNN (APRN)
Entity Type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:LYNN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:L
Other - Last Name:ESTRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:213 W 4TH NORTH ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-6541
Mailing Address - Country:US
Mailing Address - Phone:843-873-0681
Mailing Address - Fax:843-873-0538
Practice Address - Street 1:213 W 4TH NORTH ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6541
Practice Address - Country:US
Practice Address - Phone:843-873-0681
Practice Address - Fax:843-873-0538
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22670363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP5926Medicaid