Provider Demographics
NPI:1962795906
Name:PETWAY, BRITNEY L (FNP-C)
Entity type:Individual
Prefix:
First Name:BRITNEY
Middle Name:L
Last Name:PETWAY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BALD EAGLE RUN
Mailing Address - Street 2:
Mailing Address - City:OAKFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:38362-9794
Mailing Address - Country:US
Mailing Address - Phone:731-803-1310
Mailing Address - Fax:
Practice Address - Street 1:103 BALD EAGLE RUN
Practice Address - Street 2:
Practice Address - City:OAKFIELD
Practice Address - State:TN
Practice Address - Zip Code:38362-9794
Practice Address - Country:US
Practice Address - Phone:731-803-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN 166341363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner