Provider Demographics
NPI:1942093174
Name:CLARK, BRITTANY ANNE (PMHNP)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANNE
Last Name:CLARK
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 HIGHWAY 82 E
Mailing Address - Street 2:
Mailing Address - City:BELL BUCKLE
Mailing Address - State:TN
Mailing Address - Zip Code:37020-4506
Mailing Address - Country:US
Mailing Address - Phone:270-331-1769
Mailing Address - Fax:
Practice Address - Street 1:145 HIGHWAY 82 E
Practice Address - Street 2:
Practice Address - City:BELL BUCKLE
Practice Address - State:TN
Practice Address - Zip Code:37020-4506
Practice Address - Country:US
Practice Address - Phone:270-331-1769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program