Provider Demographics
NPI:1427779875
Name:PAVLOV, BRITTANY JOELLE (LPN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:JOELLE
Last Name:PAVLOV
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:JOELLE
Other - Last Name:JUDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:101 FURLONG ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3912
Mailing Address - Country:US
Mailing Address - Phone:585-305-1794
Mailing Address - Fax:
Practice Address - Street 1:101 FURLONG ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3912
Practice Address - Country:US
Practice Address - Phone:585-305-1794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333339164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse