Provider Demographics
NPI:1902046592
Name:FORT, BRITTNEY DENISE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BRITTNEY
Middle Name:DENISE
Last Name:FORT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 COGBURN CT
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-5126
Mailing Address - Country:US
Mailing Address - Phone:214-727-6230
Mailing Address - Fax:
Practice Address - Street 1:3301 UNICORN LAKE BOULEVARD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0102
Practice Address - Country:US
Practice Address - Phone:940-383-1578
Practice Address - Fax:940-382-0333
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX698382363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX316149901Medicaid
TX270716YKP5Medicare PIN
TX270716YKQLMedicare PIN
TX270716YKPWMedicare PIN