Provider Demographics
NPI:1710213624
Name:LAFREE, BRITTANY LOBBES (PA-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LOBBES
Last Name:LAFREE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:E
Other - Last Name:LOBBES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:111 NEW HAMPSHIRE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-2864
Mailing Address - Country:US
Mailing Address - Phone:802-909-2053
Mailing Address - Fax:
Practice Address - Street 1:2800 S STATE ROAD 135 STE 250
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-6223
Practice Address - Country:US
Practice Address - Phone:317-300-1788
Practice Address - Fax:317-743-8103
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001153A363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN562570HMedicare PIN
IN000000744813OtherANTHEM
IN9173650OtherAETNA
INM400061290Medicare PIN