Provider Demographics
NPI:1336881754
Name:WESLEY, BRITTANY COTEA (LPN)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:COTEA
Last Name:WESLEY
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 1:3917 BROOKDALE COURT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277
Mailing Address - Country:US
Mailing Address - Phone:904-328-9059
Mailing Address - Fax:
Practice Address - Street 1:5600 SPRING PARK RD # 101
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-5988
Practice Address - Country:US
Practice Address - Phone:904-737-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5212945164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse