Provider Demographics
NPI: | 1083615413 |
---|---|
Name: | BRITT, PATRICIA (ACNS-BC) |
Entity type: | Individual |
Prefix: | |
First Name: | PATRICIA |
Middle Name: | |
Last Name: | BRITT |
Suffix: | |
Gender: | F |
Credentials: | ACNS-BC |
Other - Prefix: | |
Other - First Name: | PATRICIA |
Other - Middle Name: | |
Other - Last Name: | NANCE |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | CNS |
Mailing Address - Street 1: | AUSTIN HEART PLLC |
Mailing Address - Street 2: | PO BOX 402669 |
Mailing Address - City: | ATLANTA |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 30384-2669 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 512-206-4341 |
Mailing Address - Fax: | 512-407-1947 |
Practice Address - Street 1: | 3801 N LAMAR BLVD |
Practice Address - Street 2: | SUITE 300 |
Practice Address - City: | AUSTIN |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78756-4080 |
Practice Address - Country: | US |
Practice Address - Phone: | 512-206-3600 |
Practice Address - Fax: | 512-454-2581 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-08-09 |
Last Update Date: | 2010-11-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 675391 | 364SA2200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 364SA2200X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 1745689-01 | Medicaid | |
TX | 8D7121 | Medicare PIN | |
TX | 8L6520 | Medicare PIN | |
TX | 1745689-01 | Medicaid |