Basic Information
Provider Information
NPI: 1982296984
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHITFIELD
FirstName: BRITTANY
MiddleName: NICOLE
NamePrefix:  
NameSuffix:  
Credential: APRN, PMHNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1940 HARRISON AVE
Address2:  
City: PANAMA CITY
State: FL
PostalCode: 324054542
CountryCode: US
TelephoneNumber: 8507630017
FaxNumber: 8506925862
Practice Location
Address1: 1940 HARRISON AVE
Address2:  
City: PANAMA CITY
State: FL
PostalCode: 324054542
CountryCode: US
TelephoneNumber: 8507630017
FaxNumber: 8506925862
Other Information
ProviderEnumerationDate: 02/10/2021
LastUpdateDate: 02/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808XAPRN11011459FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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