Healthcare Provider Details

I. General information

NPI: 1639086135
Provider Name (Legal Business Name): BRIANNE KAY WOODRAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 W 25TH ST
SCOTTSBLUFF NE
69361-1512
US

IV. Provider business mailing address

606 W 25TH ST
SCOTTSBLUFF NE
69361-1512
US

V. Phone/Fax

Practice location:
  • Phone: 308-672-8600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number168016
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: