Healthcare Provider Details

I. General information

NPI: 1457150294
Provider Name (Legal Business Name): BRIANA GILLILAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 HACKBERRY CT APT 2302
BELLEVUE NE
68005-2057
US

IV. Provider business mailing address

908 HACKBERRY CT APT 2302
BELLEVUE NE
68005-2057
US

V. Phone/Fax

Practice location:
  • Phone: 402-812-4443
  • Fax: 402-812-4443
Mailing address:
  • Phone: 402-812-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: