Provider Demographics
NPI:1205546264
Name:BYRD, BRITTANY JUSTINE (STNA INDEPENDENT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:JUSTINE
Last Name:BYRD
Suffix:
Gender:F
Credentials:STNA INDEPENDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 MILL RUN RD LOT 144
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-8812
Mailing Address - Country:US
Mailing Address - Phone:740-970-3221
Mailing Address - Fax:
Practice Address - Street 1:178 MILL RUN RD LOT 144
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-8812
Practice Address - Country:US
Practice Address - Phone:740-970-3221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
OH374U00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker