Basic Information
| Provider Information | |||||||||
| NPI: | 1942543061 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANNIGAN | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | |||||||||
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| Credential: | CNM | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | WILLIAMS | ||||||||
| OtherFirstName: | BRITTANY | ||||||||
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| OtherCredential: | CNM | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3905 LOWER SAXON AVE | ||||||||
| Address2: | |||||||||
| City: | NORTH LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8588808357 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4700 N LAS VEGAS BLVD | ||||||||
| Address2: | MIKE O'CALLAGHAN FEDERAL MEDICAL CENTER - WOMEN'S HEALT | ||||||||
| City: | NELLIS AFB | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026532300 | ||||||||
| FaxNumber: | 7026532109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2013 | ||||||||
| LastUpdateDate: | 05/09/2017 | ||||||||
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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 | 367A00000X | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367A00000X | 235631 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.