Provider Demographics
NPI:1770661068
Name:BRITT, VICKI LYNN (ARNP CS)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:LYNN
Last Name:BRITT
Suffix:
Gender:F
Credentials:ARNP CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14219 SMOKEY POINT BLVD BLDG 1
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98271-8906
Mailing Address - Country:US
Mailing Address - Phone:360-631-3781
Mailing Address - Fax:360-403-9137
Practice Address - Street 1:14219 SMOKEY POINT BLVD BLDG 1
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-8906
Practice Address - Country:US
Practice Address - Phone:421-215-9907
Practice Address - Fax:360-403-9137
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00141532364SP0808X
WAAP30005968364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
6AB24765Medicare ID - Type Unspecified