Provider Demographics
NPI:1487955340
Name:STANG, BRITTANY ANN (RN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:STANG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 WILLOW ST W APT 1
Mailing Address - Street 2:
Mailing Address - City:DETROIT LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:56501-3810
Mailing Address - Country:US
Mailing Address - Phone:320-267-7581
Mailing Address - Fax:
Practice Address - Street 1:14 MAIN AVE S
Practice Address - Street 2:
Practice Address - City:BAGLEY
Practice Address - State:MN
Practice Address - Zip Code:56621-8158
Practice Address - Country:US
Practice Address - Phone:218-694-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-1927959163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse