Provider Demographics
NPI:1558028456
Name:CRANDELL, BRITTANY ELLEEN (MSN, APRN)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ELLEEN
Last Name:CRANDELL
Suffix:
Gender:F
Credentials:MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 ARLINGTON RD APT 15
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-1134
Mailing Address - Country:US
Mailing Address - Phone:937-825-7191
Mailing Address - Fax:
Practice Address - Street 1:6251 MIAMI VALLEY WAY STE 210A
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-5464
Practice Address - Country:US
Practice Address - Phone:937-236-2155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-26
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0030350207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine