Provider Demographics
NPI:1063176196
Name:SWAN, BRITTANY ALEXANDRIA (RN)
Entity type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:ALEXANDRIA
Last Name:SWAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4688 GREENROCK CT
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-4770
Mailing Address - Country:US
Mailing Address - Phone:510-512-8386
Mailing Address - Fax:
Practice Address - Street 1:1978 CONTRA COSTA BLVD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3306
Practice Address - Country:US
Practice Address - Phone:925-688-0684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95246615163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse