Provider Demographics
NPI:1316320765
Name:ADDIS, BRITTNEY D (ARNP)
Entity type:Individual
Prefix:MS
First Name:BRITTNEY
Middle Name:D
Last Name:ADDIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 8TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-2102
Mailing Address - Country:US
Mailing Address - Phone:615-714-7942
Mailing Address - Fax:
Practice Address - Street 1:8001 9TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4109
Practice Address - Country:US
Practice Address - Phone:727-577-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9329441363LF0000X
FL9329441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018663400Medicaid
FLIK367YMedicare PIN