Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 28191824A | IN |
NPI | 1215394507 |
---|---|
Provider Name | Mrs. Brittany Withrow |
First Address | Indianapolis, IN 46202-5166 |
Second Address | Indianapolis, IN 46202-5166 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2016 |
Last Update Date | 22/11/2021 |