Provider Demographics
NPI:1740044320
Name:KNOX, BRITTANY NICOLE (BS)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICOLE
Last Name:KNOX
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:NICOLE
Other - Last Name:WAKEFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4008 S FEDERAL WAY APT D101
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-5243
Mailing Address - Country:US
Mailing Address - Phone:208-315-7814
Mailing Address - Fax:
Practice Address - Street 1:4008 S FEDERAL WAY APT D101
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83716-5243
Practice Address - Country:US
Practice Address - Phone:208-315-7814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management