Provider Demographics
NPI:1710531249
Name:VILLONDO, BRITTANY BARTHOL (CPM)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:BARTHOL
Last Name:VILLONDO
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:MISS
Other - First Name:BRITTANY
Other - Middle Name:LAUREN
Other - Last Name:BARTHOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2142 E RIVER TRACE DR APT 7
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2747
Mailing Address - Country:US
Mailing Address - Phone:901-652-1888
Mailing Address - Fax:
Practice Address - Street 1:2142 E RIVER TRACE DR APT 7
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-2747
Practice Address - Country:US
Practice Address - Phone:901-652-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCPM0000000073367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife