Provider Demographics
NPI:1790322378
Name:ANDERSON, BRITTNEY (BSN, RN, CLC)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:BSN, RN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2429 BISSONNET ST APT 4102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1451
Mailing Address - Country:US
Mailing Address - Phone:832-749-8600
Mailing Address - Fax:
Practice Address - Street 1:547 CHAPEL CROSS DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-1676
Practice Address - Country:US
Practice Address - Phone:314-456-2532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017021814163WL0100X, 163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant