Provider Demographics
NPI:1689497208
Name:LAVY, BRITTANY ANNE
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANNE
Last Name:LAVY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W PLUM ST
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-2232
Mailing Address - Country:US
Mailing Address - Phone:419-230-3802
Mailing Address - Fax:
Practice Address - Street 1:4611 EAST RD
Practice Address - Street 2:
Practice Address - City:ELIDA
Practice Address - State:OH
Practice Address - Zip Code:45807-1520
Practice Address - Country:US
Practice Address - Phone:419-230-3802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHL6J4H3B6246RP1900X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy