1497352439 NPI number — MRS. BRITTANY M BILBERRY APRN

Table of content: MRS. BRITTANY M BILBERRY APRN (NPI 1497352439)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497352439 NPI number — MRS. BRITTANY M BILBERRY APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BILBERRY
Provider First Name:
BRITTANY
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARRETT
Provider Other First Name:
BRITTANY
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497352439
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1861 N ROCK RD STE 310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WICHITA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67206-1264
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
316-612-1833
Provider Business Mailing Address Fax Number:
316-612-2420

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2051 E MARY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARDEN CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67846-3617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-277-9092
Provider Business Practice Location Address Fax Number:
620-315-4114
Provider Enumeration Date:
10/02/2020

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: 363L00000X , with the licence number:  79584 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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