Provider Demographics
NPI:1932770732
Name:CALLAHAN, BRITTNEY SMITH (NP-C)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:SMITH
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 GORE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:NAKINA
Mailing Address - State:NC
Mailing Address - Zip Code:28455-3500
Mailing Address - Country:US
Mailing Address - Phone:910-770-6602
Mailing Address - Fax:
Practice Address - Street 1:680 GORE LAKE RD
Practice Address - Street 2:
Practice Address - City:NAKINA
Practice Address - State:NC
Practice Address - Zip Code:28455-3500
Practice Address - Country:US
Practice Address - Phone:910-770-6602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily