Provider Demographics
NPI:1821349614
Name:PICKARD, BRITTANY GAYLE (DOULA)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:GAYLE
Last Name:PICKARD
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 7TH ST W
Mailing Address - Street 2:114
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-6921
Mailing Address - Country:US
Mailing Address - Phone:706-455-2753
Mailing Address - Fax:
Practice Address - Street 1:2835 7TH ST W
Practice Address - Street 2:114
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-6921
Practice Address - Country:US
Practice Address - Phone:706-455-2753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
335002912374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula