Provider Demographics
NPI:1518113695
Name:WALL, BRITTANY NEWSOME (NNP-BC, PNP-PC/AC)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:NEWSOME
Last Name:WALL
Suffix:
Gender:F
Credentials:NNP-BC, PNP-PC/AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 CYPRESSWOOD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7746
Mailing Address - Country:US
Mailing Address - Phone:214-605-0546
Mailing Address - Fax:
Practice Address - Street 1:6620 CYPRESSWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7746
Practice Address - Country:US
Practice Address - Phone:214-605-0546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX674045363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care