Provider Demographics
NPI:1689324345
Name:SPROUL, BRITTANY MARY (AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:MARY
Last Name:SPROUL
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 HOLLY MILL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-7174
Mailing Address - Country:US
Mailing Address - Phone:706-429-6766
Mailing Address - Fax:
Practice Address - Street 1:143 HOLLY MILL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-7174
Practice Address - Country:US
Practice Address - Phone:706-429-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN250114363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care