Provider Demographics
NPI:1639583719
Name:KERN, BRITTANY S (MD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:S
Last Name:KERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:2525 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-3421
Practice Address - Country:US
Practice Address - Phone:765-289-6381
Practice Address - Fax:765-281-2620
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2020-08-03
Deactivation Date:2019-06-25
Deactivation Code:
Reactivation Date:2019-07-11
Provider Licenses
StateLicense IDTaxonomies
IN01083964A208600000X
MA278554208600000X
MI4301104983208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN02083964AOtherSTATE LICENSE