Provider Demographics
NPI:1942506340
Name:MASSIE, BRITTANY NICHOLE (STNA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICHOLE
Last Name:MASSIE
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3165 WASHINGTON WATERLOO RD NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-9072
Mailing Address - Country:US
Mailing Address - Phone:406-450-3799
Mailing Address - Fax:
Practice Address - Street 1:3165 WASHINGTON WATERLOO RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-9072
Practice Address - Country:US
Practice Address - Phone:406-450-3799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH322692140310376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide