Provider Demographics
NPI:1336271899
Name:BRITT, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BRITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1288
Mailing Address - Street 2:580 FARRINGDOM STREET
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28359
Mailing Address - Country:US
Mailing Address - Phone:910-671-9629
Mailing Address - Fax:910-671-9630
Practice Address - Street 1:580 FARRINGDOM STREET
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358
Practice Address - Country:US
Practice Address - Phone:910-671-9629
Practice Address - Fax:910-671-9630
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3741235Z00000X
NC270235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSAN039Medicaid