Provider Demographics
NPI:1912469230
Name:WALDEN, BRITTNEY ALISE (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:ALISE
Last Name:WALDEN
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 LUTHER BECK RD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32145-5714
Mailing Address - Country:US
Mailing Address - Phone:904-669-1752
Mailing Address - Fax:
Practice Address - Street 1:264 PALM COAST PKWY NE
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8217
Practice Address - Country:US
Practice Address - Phone:386-446-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001858207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine