NPI Code Details Logo

NPI 1366331761

NPI 1366331761 : BRIANNA MOHLER PA : FORT WAYNE, IN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1366331761
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    BRIANNA MOHLER PA
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/30/2025
-----------------------------------------------------
    Last Update Date     |    11/14/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    11143 PARKVIEW PLAZA DR STE 200 
-----------------------------------------------------
    City                 |    FORT WAYNE
-----------------------------------------------------
    State                |    IN
-----------------------------------------------------
    Zip                  |    46845-1728
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    260-266-8820
-----------------------------------------------------
    Fax                  |    260-266-8829
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    11109 PARKVIEW PLAZA DR # 117 
-----------------------------------------------------
    City                 |    FORT WAYNE
-----------------------------------------------------
    State                |    IN
-----------------------------------------------------
    Zip                  |    46845-1701
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363A00000X
-----------------------------------------------------
    Taxonomy Name        |    Physician Assistant
-----------------------------------------------------
    License Number       |    10005076A
-----------------------------------------------------
    License Number State |    IN
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.