Provider Demographics
NPI:1770046690
Name:PICKENS, BRITTANY (CRNA)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:
Last Name:PICKENS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:BALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:6232 VERA LN
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-6494
Mailing Address - Country:US
Mailing Address - Phone:901-461-5219
Mailing Address - Fax:
Practice Address - Street 1:6232 VERA LN
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-6494
Practice Address - Country:US
Practice Address - Phone:901-461-5219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901562367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered