Provider Demographics
NPI:1962583948
Name:BRITT, AMY C (CRNA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:BRITT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:V
Other - Last Name:CALLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:256 SAINT ANTHONY RD
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:KY
Mailing Address - Zip Code:42376-9730
Mailing Address - Country:US
Mailing Address - Phone:270-684-5005
Mailing Address - Fax:270-926-4432
Practice Address - Street 1:815 E PARRISH AVE
Practice Address - Street 2:SUITE 460
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3222
Practice Address - Country:US
Practice Address - Phone:270-684-5005
Practice Address - Fax:270-926-4432
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1117A367500000X
IN28220785A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY74111717Medicaid