Provider Demographics
NPI:1801525043
Name:NIELSEN, BRITTANY SHEA (PA-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:SHEA
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 S DEL NORTE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2755
Mailing Address - Country:US
Mailing Address - Phone:864-380-0639
Mailing Address - Fax:
Practice Address - Street 1:1330 BOILING SPRINGS RD STE 1600
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-4219
Practice Address - Country:US
Practice Address - Phone:864-582-6396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-05
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC1188973363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical