Provider Demographics
NPI:1275198699
Name:CLAYTON, BRITTANY REGAN (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:REGAN
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 SOUTHWIND DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-6339
Mailing Address - Country:US
Mailing Address - Phone:507-459-2378
Mailing Address - Fax:
Practice Address - Street 1:14682 PENNOCK AVE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7429
Practice Address - Country:US
Practice Address - Phone:952-431-5774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2139377163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant