Individual
BRITTANY NICHOL HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
700 KIMBER LANE, EVANSVILLE, IN 47715-2803
(812) 476-7111
(812) 476-7117
Mailing address
PO BOX 21890, BELFAST, ME 04915-4115
(502) 907-0356
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3013026
KY
363LF0000X
Family Nurse Practitioner
Primary
71004067A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001155086
ANTHEM ID
IN
01
—
1554303
WELLCARE ID
—
01
—
201287400B
MEDICAID GROUP ID
IN
05
—
300015279
—
IN
05
—
7100498190
—
KY
01
—
9815905
AETNA PIN
IN
01
—
CS1817800169
CARESOURCE ID
IN
01
—
PDZ000000063404
AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
KY
Enumeration date
06/05/2012
Last updated
06/14/2022
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