1033439617 NPI number — MISS BRITTNEY NICOLE WRIGHT MCD

Table of content: MISS BRITTNEY NICOLE WRIGHT MCD (NPI 1033439617)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033439617 NPI number — MISS BRITTNEY NICOLE WRIGHT MCD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WRIGHT
Provider First Name:
BRITTNEY
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MCD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033439617
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
113 OAKLEAF DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SLIDELL
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70461-5007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-502-8990
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 GRAVIER STREET LSUHSC-HUMAN DEVELOPMENT CENTER
Provider Second Line Business Practice Location Address:
SAHP BUILDING 10TH FLOOR
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-914-2833
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  CLINICIAL FELLOWSHIP , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)