Provider Demographics
NPI:1588303010
Name:MCKINNEY, BRITTAN AMANDA (PA-C)
Entity type:Individual
Prefix:
First Name:BRITTAN
Middle Name:AMANDA
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRITTAN
Other - Middle Name:AMANDA
Other - Last Name:RIESBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9255
Mailing Address - Fax:515-875-9223
Practice Address - Street 1:5950 UNIVERSITY AVE STE 231
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8233
Practice Address - Country:US
Practice Address - Phone:515-875-9090
Practice Address - Fax:515-875-9312
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA112989363A00000X
NE2756363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant