Healthcare Provider Details

I. General information

NPI: 1831801125
Provider Name (Legal Business Name): BRIANA RULLMANN AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 12/19/2022
Certification Date: 12/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9489 CHARDON CIR APT 102
WEST CHESTER OH
45069-3032
US

IV. Provider business mailing address

9489 CHARDON CIR APT 102
WEST CHESTER OH
45069-3032
US

V. Phone/Fax

Practice location:
  • Phone: 513-289-5359
  • Fax:
Mailing address:
  • Phone: 513-289-5359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0032509
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.451184
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: