Provider Demographics
NPI:1881262376
Name:BOLDT, BRITTNAI N (APRN)
Entity type:Individual
Prefix:MRS
First Name:BRITTNAI
Middle Name:N
Last Name:BOLDT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BRITTNAI
Other - Middle Name:N
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1839 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8900
Mailing Address - Country:US
Mailing Address - Phone:727-322-1054
Mailing Address - Fax:727-821-7213
Practice Address - Street 1:PROFESSIONAL HEALTH CARE OF PINELLAS LLC
Practice Address - Street 2:1839 CENTRAL AVE
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33714-8900
Practice Address - Country:US
Practice Address - Phone:727-322-1054
Practice Address - Fax:727-821-7213
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily