MEDICARE: BRIANNA RUTH OEXMANN NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	95022258	CA

General Provider Information

NPI Number	:	1023734704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA RUTH OEXMANN NP

Provider Business Mailing Address
First Line	:	135 S STATE COLLEGE BLVD STE 350
Second Line	:
City	:	BREA
State	:	CA
Zip	:	92821-5814
Country	:	US
Telephone Number	:	888-777-1945
Fax Number	:	805-413-9099

Provider Business Practice Location Address
First Line	:	501 N CENTRAL AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-1901
Country	:	US
Telephone Number	:	888-777-1945
Fax Number	:	805-413-9099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2022
Last Update Date	:	10/14/2022

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