Provider Demographics
NPI:1730769308
Name:BRITTON, MAXIE (RN, CIC-CSP,MA GC-C)
Entity type:Individual
Prefix:MRS
First Name:MAXIE
Middle Name:
Last Name:BRITTON
Suffix:
Gender:F
Credentials:RN, CIC-CSP,MA GC-C
Other - Prefix:MRS
Other - First Name:MAXCINE
Other - Middle Name:
Other - Last Name:BRITTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CIC-CSP,MA GC-C
Mailing Address - Street 1:427 LAKE CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-9004
Mailing Address - Country:US
Mailing Address - Phone:601-473-5430
Mailing Address - Fax:601-510-9871
Practice Address - Street 1:427 LAKE CASTLE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-9004
Practice Address - Country:US
Practice Address - Phone:601-473-5430
Practice Address - Fax:601-510-9871
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR539597101YP2500X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty