=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881976082
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSALIE M BRIAN APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2011
-----------------------------------------------------
Last Update Date | 12/04/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1294 S JONES BLVD
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89146-1284
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-877-1887
-----------------------------------------------------
Fax | 702-877-4536
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1294 S JONES BLVD
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89146-1284
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-877-1887
-----------------------------------------------------
Fax | 702-877-4536
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | 75600
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | APRN001313
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------