Provider Demographics
NPI:1124830518
Name:CHAMPAGNE, BRITTANY (PA-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:CHAMPAGNE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078
Mailing Address - Country:US
Mailing Address - Phone:860-668-1211
Mailing Address - Fax:
Practice Address - Street 1:230 MOUNTAIN RD
Practice Address - Street 2:SUITE C
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078
Practice Address - Country:US
Practice Address - Phone:860-668-1211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical