Provider Demographics
NPI:1871997742
Name:ELLIS, BRITTANY PIRKO (RN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:PIRKO
Last Name:ELLIS
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:1208 AUGUSTA ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4084
Practice Address - Country:US
Practice Address - Phone:864-522-6200
Practice Address - Fax:864-522-6205
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC19111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP3014Medicaid