Provider Demographics
NPI:1265159628
Name:MCCROY, BRITTANY LEIGH (LPN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEIGH
Last Name:MCCROY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4881 N 105TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-3955
Mailing Address - Country:US
Mailing Address - Phone:920-791-1322
Mailing Address - Fax:
Practice Address - Street 1:4881 N 105TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-3955
Practice Address - Country:US
Practice Address - Phone:920-791-1322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI32247831164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse