Provider Demographics
NPI:1801236351
Name:SIRGO, BRITTA L
Entity type:Individual
Prefix:
First Name:BRITTA
Middle Name:L
Last Name:SIRGO
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 1:3515 MASSILLON RD
Mailing Address - Street 2:STE 300
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7854
Mailing Address - Country:US
Mailing Address - Phone:330-899-9350
Mailing Address - Fax:330-899-9395
Practice Address - Street 1:4444 ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-9508
Practice Address - Country:US
Practice Address - Phone:330-896-6111
Practice Address - Fax:330-634-1329
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.14797-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0092368Medicaid
OH0092368Medicaid