Provider Demographics
NPI:1619570710
Name:WARREN, BRITTANY MICHELLE
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MICHELLE
Last Name:WARREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 CLOUGH POND RD
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:NH
Mailing Address - Zip Code:03307-1105
Mailing Address - Country:US
Mailing Address - Phone:603-573-0815
Mailing Address - Fax:
Practice Address - Street 1:216 CLOUGH POND RD
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:NH
Practice Address - Zip Code:03307-1105
Practice Address - Country:US
Practice Address - Phone:603-573-0815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer