Provider Demographics
NPI:1134089378
Name:NELSON, BRITTANY (BS QIDP)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:BS QIDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 W KALAMAZOO AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-3334
Mailing Address - Country:US
Mailing Address - Phone:269-553-8060
Mailing Address - Fax:
Practice Address - Street 1:418 W KALAMAZOO AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-3334
Practice Address - Country:US
Practice Address - Phone:269-553-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty