Provider Demographics
NPI:1740952829
Name:PROFFIT, BRITTNI DEVEN (CNA)
Entity type:Individual
Prefix:
First Name:BRITTNI
Middle Name:DEVEN
Last Name:PROFFIT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6905 SHADY WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:RIO LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:95673-2136
Mailing Address - Country:US
Mailing Address - Phone:916-204-8652
Mailing Address - Fax:
Practice Address - Street 1:1161 CIRBY WAY
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4421
Practice Address - Country:US
Practice Address - Phone:916-782-1238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01202212376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide