Healthcare Provider Details

I. General information

NPI: 1881320554
Provider Name (Legal Business Name): BRILES CHRISTENSON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W WALNUT ST.
OGDEN IA
50212-3060
US

IV. Provider business mailing address

1015 UNION STREET
BOONE IA
50036-4821
US

V. Phone/Fax

Practice location:
  • Phone: 515-275-2417
  • Fax: 515-275-4678
Mailing address:
  • Phone: 515-368-7504
  • Fax: 515-355-3491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number126965
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: