Provider Demographics
NPI:1194478578
Name:ARD, BRITTANY (LPN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:ARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 JULIA DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:LA
Mailing Address - Zip Code:70094-2825
Mailing Address - Country:US
Mailing Address - Phone:504-360-4164
Mailing Address - Fax:
Practice Address - Street 1:172 JULIA DR
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:LA
Practice Address - Zip Code:70094-2825
Practice Address - Country:US
Practice Address - Phone:504-360-4164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA20140880164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse