Healthcare Provider Details

I. General information

NPI: 1225340938
Provider Name (Legal Business Name): BRIANNE NICOLE PLANTE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIANNE NICOLE PAULSON D.O.

II. Dates (important events)

Enumeration Date: 07/10/2010
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 W. LANE AVE STE D
COLUMBUS OH
43221-3544
US

IV. Provider business mailing address

1315 W. LANE AVE STE D
COLUMBUS OH
43221-3544
US

V. Phone/Fax

Practice location:
  • Phone: 614-457-4827
  • Fax: 614-326-0250
Mailing address:
  • Phone: 614-457-4827
  • Fax: 614-326-0250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34011258
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: