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General NPI Number Information
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NPI Number | 1730818568
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Entity Type | Individual
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Provider Name | BRIANNA PICONE MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 4601 W BONANZA RD
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City | LAS VEGAS
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State | NV
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Zip | 89107-2146
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Country | US
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Telephone | 951-500-4559
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Fax |
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Provider Business Mailing Address
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Address Line | 831 CORONADO CENTER DR APT 16111
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City | HENDERSON
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State | NV
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Zip | 89052-4277
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Country | US
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Telephone | 951-500-4559
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0506377
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License Number State | NV
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