Provider Demographics
NPI:1205517695
Name:MCGUIRE, BRITTANY ANNE (CRNA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANNE
Last Name:MCGUIRE
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ANNE
Other - Last Name:ROUGHSEDGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:5096 GAINESWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-7563
Mailing Address - Country:US
Mailing Address - Phone:717-578-8482
Mailing Address - Fax:
Practice Address - Street 1:3072 TEW AVE
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-8162
Practice Address - Country:US
Practice Address - Phone:717-578-8482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11033048367500000X
VA0024191244367500000X
FL9592947163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse