Provider Demographics
NPI:1770461840
Name:GOOD, BRITTANY S (LPN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:S
Last Name:GOOD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:S
Other - Last Name:VESTAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2002C MIDDLETOWN DR
Mailing Address - Street 2:
Mailing Address - City:MAHOMET
Mailing Address - State:IL
Mailing Address - Zip Code:61853-4231
Mailing Address - Country:US
Mailing Address - Phone:217-778-3620
Mailing Address - Fax:
Practice Address - Street 1:2002C MIDDLETOWN DR
Practice Address - Street 2:
Practice Address - City:MAHOMET
Practice Address - State:IL
Practice Address - Zip Code:61853-4231
Practice Address - Country:US
Practice Address - Phone:217-778-3620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043125266164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse