Provider Demographics
NPI:1376911057
Name:DIFANI, BRITTANY A (PA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:A
Last Name:DIFANI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:A
Other - Last Name:LANZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1221 DISK DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-6638
Mailing Address - Country:US
Mailing Address - Phone:415-773-3863
Mailing Address - Fax:
Practice Address - Street 1:8385 DIVISION RD
Practice Address - Street 2:
Practice Address - City:WHITE CITY
Practice Address - State:OR
Practice Address - Zip Code:97503-1176
Practice Address - Country:US
Practice Address - Phone:541-826-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA174760363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant