Provider Demographics
NPI:1588984884
Name:ROSS, BRITTANY M (ARNP)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:M
Last Name:ROSS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:BRITTANY
Other - Middle Name:M
Other - Last Name:COFFEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:4915 NORTON HEALTHCARE BLVD STE 301
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2866
Practice Address - Country:US
Practice Address - Phone:502-394-6390
Practice Address - Fax:502-394-6388
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006751363L00000X
KY6751P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100130740Medicaid
KY50063068OtherPASSPORT-CTS
KY201013000OtherMEDICAID-IN
KY157465OtherSIHO-CTS
KY000000857840OtherANTHEM-CTS
KY000000857840OtherANTHEM-CTS