Provider Demographics
NPI:1386377141
Name:DARGAVELL, BRITTANY
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:
Last Name:DARGAVELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1398 TWIN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SADIEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40370-9310
Mailing Address - Country:US
Mailing Address - Phone:859-588-6525
Mailing Address - Fax:
Practice Address - Street 1:1398 TWIN CREEK RD
Practice Address - Street 2:
Practice Address - City:SADIEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40370-9310
Practice Address - Country:US
Practice Address - Phone:859-588-6525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016947363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily