Provider Demographics
NPI:1508463027
Name:FAT-DENATSOSIE, BRITTANY JAMAICA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:JAMAICA
Last Name:FAT-DENATSOSIE
Suffix:
Gender:F
Credentials:FNP-C
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 7278
Mailing Address - Street 2:
Mailing Address - City:PAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:86040-7278
Mailing Address - Country:US
Mailing Address - Phone:769-687-3984
Mailing Address - Fax:
Practice Address - Street 1:467 VISTA AVE
Practice Address - Street 2:
Practice Address - City:PAGE
Practice Address - State:AZ
Practice Address - Zip Code:86040-1478
Practice Address - Country:US
Practice Address - Phone:928-645-8123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ247435363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily