Provider Demographics
NPI:1568811040
Name:FOX, BRITTANY NITA (OD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NITA
Last Name:FOX
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12099 513TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMBOY
Mailing Address - State:MN
Mailing Address - Zip Code:56010-4505
Mailing Address - Country:US
Mailing Address - Phone:507-525-1368
Mailing Address - Fax:
Practice Address - Street 1:435 S GROVE ST
Practice Address - Street 2:
Practice Address - City:BLUE EARTH
Practice Address - State:MN
Practice Address - Zip Code:56013-2604
Practice Address - Country:US
Practice Address - Phone:507-526-2222
Practice Address - Fax:507-526-3927
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3474152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist