Provider Demographics
NPI:1962629246
Name:BRANDT, BRITTANY LEE (NP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEE
Last Name:BRANDT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:GRACE
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5887 KERR DR
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-3028
Mailing Address - Country:US
Mailing Address - Phone:406-830-0148
Mailing Address - Fax:
Practice Address - Street 1:9801 VALLEY GROVE DR
Practice Address - Street 2:
Practice Address - City:LOLO
Practice Address - State:MT
Practice Address - Zip Code:59847-8617
Practice Address - Country:US
Practice Address - Phone:406-273-4633
Practice Address - Fax:406-273-4707
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-28614163W00000X
MTNUR-APRN-LIC-100513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse