Individual
BRITTANY MARIE KENT KHOTMANIVONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-0935
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-0935
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
32563
TN
363LA2100X
Acute Care Nurse Practitioner
APRN-2563
HI
Other
Enumeration date
11/08/2018
Last updated
08/19/2024
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