Provider Demographics
NPI: | 1225408214 |
---|---|
Name: | WANGSNESS, BRITTANY COLE (DNP) |
Entity type: | Individual |
Prefix: | DR |
First Name: | BRITTANY |
Middle Name: | COLE |
Last Name: | WANGSNESS |
Suffix: | |
Gender: | F |
Credentials: | DNP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2901 S 4TH AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | SIOUX FALLS |
Mailing Address - State: | SD |
Mailing Address - Zip Code: | 57105-4928 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 605-480-1804 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5011 S LOUISE AVE |
Practice Address - Street 2: | |
Practice Address - City: | SIOUX FALLS |
Practice Address - State: | SD |
Practice Address - Zip Code: | 57108-2268 |
Practice Address - Country: | US |
Practice Address - Phone: | 605-275-6128 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2015-10-02 |
Last Update Date: | 2015-10-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
SD | CP000987 | 363L00000X, 363LF0000X, 363LP2300X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |