Provider Demographics
NPI:1881120541
Name:FUGATE, BRITTANY RENEE (HHA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:RENEE
Last Name:FUGATE
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 SHEFFIELD ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-6447
Mailing Address - Country:US
Mailing Address - Phone:513-465-8949
Mailing Address - Fax:
Practice Address - Street 1:1609 SHEFFIELD ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-6447
Practice Address - Country:US
Practice Address - Phone:513-465-8949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide