Wallace, Brittany Asta

Wallace, Brittany Asta is an individual health care provider with primary practice located at 510 North Street , Pittsfield MA 01201. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wallace, Brittany Asta can be contacted via phone (413) 447-2351.

Contact Information

Primary practice address
510 North Street Pittsfield MA 01201
Fax: (413) 445-7009
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN2258013 Massachusetts

Profile Details

NPI number 1215363239
LBN Legal business name Wallace, Brittany Asta
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2013
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215363239 NPPES
Massachusetts MEDICAID 110120598A

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