Provider Demographics
NPI:1588003651
Name:TICE, BRITTANY R (PA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:R
Last Name:TICE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:836 E 65TH ST STE 22
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4493
Mailing Address - Country:US
Mailing Address - Phone:912-819-2430
Mailing Address - Fax:912-819-3320
Practice Address - Street 1:509 FOUNDATION DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31408-2215
Practice Address - Country:US
Practice Address - Phone:912-819-2430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA006876363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant