Provider Demographics
NPI:1053820639
Name:WILSON, BRITTANY MORRELL (PA-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MORRELL
Last Name:WILSON
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:MORRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6535 N ROCHESTER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306
Mailing Address - Country:US
Mailing Address - Phone:248-813-0060
Mailing Address - Fax:248-813-0066
Practice Address - Street 1:6535 N ROCHESTER RD STE 102
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306
Practice Address - Country:US
Practice Address - Phone:248-813-0060
Practice Address - Fax:248-813-0066
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601008377363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical