Basic Information
| Provider Information | |||||||||
| NPI: | 1598919219 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FEVRIER | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1076 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029045760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018617711 | ||||||||
| FaxNumber: | 4014215710 | ||||||||
| Practice Location | |||||||||
| Address1: | 1076 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029045760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018617711 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2008 | ||||||||
| LastUpdateDate: | 10/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN03288 | RI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 1041C0700X | CSW01180 | RI | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | APRN03288 | 01 | RI | AANP/STATE OF RI | OTHER | CSW01180 | 01 | RI | LICENSE | OTHER |