Provider Demographics
NPI:1548961162
Name:AMOS, BRITTNI K (CNA, CMA)
Entity type:Individual
Prefix:
First Name:BRITTNI
Middle Name:K
Last Name:AMOS
Suffix:
Gender:F
Credentials:CNA, CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5811 KINGS GAP RD
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:GA
Mailing Address - Zip Code:31826-2701
Mailing Address - Country:US
Mailing Address - Phone:706-577-2927
Mailing Address - Fax:
Practice Address - Street 1:450 NEWNAN LAKES BLVD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-6342
Practice Address - Country:US
Practice Address - Phone:770-400-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030041024376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide