Basic Information
| Provider Information | |||||||||
| NPI: | 1811435118 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PITRE | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | KELLY | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 108 6TH AVE | ||||||||
| Address2: | |||||||||
| City: | KINDER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706483187 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3377389494 | ||||||||
| FaxNumber: | 3377389449 | ||||||||
| Practice Location | |||||||||
| Address1: | 108 6TH AVE | ||||||||
| Address2: | |||||||||
| City: | KINDER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706483187 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3377389494 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2017 | ||||||||
| LastUpdateDate: | 02/21/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP09149 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | AP09149 | 01 | LA | LOUISIANA STATE BOARD OF NURSING | OTHER |