Provider Demographics
NPI:1558781112
Name:JARRELL, BRITTANY A (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:A
Last Name:JARRELL
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3927
Mailing Address - Country:US
Mailing Address - Phone:215-585-2144
Mailing Address - Fax:
Practice Address - Street 1:6920 MIRAMAR RD STE 329
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2642
Practice Address - Country:US
Practice Address - Phone:215-585-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX764748363L00000X
CA95010578363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner