Provider Demographics
NPI:1689161226
Name:CHARLTON, BRITTANY (LPN)
Entity Type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:
Last Name:CHARLTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2479 E 64TH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-1747
Mailing Address - Country:US
Mailing Address - Phone:216-303-0432
Mailing Address - Fax:
Practice Address - Street 1:2479 E 64TH ST APT 5
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-1747
Practice Address - Country:US
Practice Address - Phone:216-303-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.152316164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse