Provider Demographics
NPI:1770210577
Name:PRUNIER, BRITTNEY MORGAN
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:MORGAN
Last Name:PRUNIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460A ALBERT ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14904-2312
Mailing Address - Country:US
Mailing Address - Phone:607-425-3591
Mailing Address - Fax:
Practice Address - Street 1:460A ALBERT ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14904-2312
Practice Address - Country:US
Practice Address - Phone:607-425-3591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344669164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty