Healthcare Provider Details

I. General information

NPI: 1912493180
Provider Name (Legal Business Name): BRIANNA RENEE HIBBARD ARNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3914 MURPHY CANYON RD STE A103
SAN DIEGO CA
92123-4414
US

IV. Provider business mailing address

3914 MURPHY CANYON RD STE A103
SAN DIEGO CA
92123-4414
US

V. Phone/Fax

Practice location:
  • Phone: 858-737-4260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95020576
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11002531
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12.007752
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95280076
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: