Healthcare Provider Details

I. General information

NPI: 1649886029
Provider Name (Legal Business Name): BRIANNE LEE WESSELS ARNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 11/02/2023
Certification Date: 09/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SOUTH STORY STREET
BOONE IA
50036-4739
US

IV. Provider business mailing address

120 SOUTH STORY STREET
BOONE IA
50036-4739
US

V. Phone/Fax

Practice location:
  • Phone: 515-433-8585
  • Fax:
Mailing address:
  • Phone: 515-975-4613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA160636
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number109223
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: