Provider Demographics
NPI:1598909129
Name:LEDBURY, BRITTNEY L (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:L
Last Name:LEDBURY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6042 KEVIN DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-2482
Mailing Address - Country:US
Mailing Address - Phone:901-361-8410
Mailing Address - Fax:
Practice Address - Street 1:1340 S DAMEN AVE STE 400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1169
Practice Address - Country:US
Practice Address - Phone:877-663-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014144363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4318537OtherBLUE CROSS BLUE SHIELD
TN103G707029Medicare PIN
TN4318537OtherBLUE CROSS BLUE SHIELD