Provider Demographics
NPI:1386376747
Name:LABOMBARD, BRITTNEY NICOLE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BRITTNEY
Middle Name:NICOLE
Last Name:LABOMBARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:BRITTNEY
Other - Middle Name:NICOLE
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4972 WABASH PINE CT
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-2768
Mailing Address - Country:US
Mailing Address - Phone:850-619-2996
Mailing Address - Fax:
Practice Address - Street 1:9400 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5752
Practice Address - Country:US
Practice Address - Phone:850-469-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-25
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF06220712363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily