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NPI Code Detail

MEDICARE: BRIANNA HAILEY JORGENSEN

MEDICARE: BRIANNA HAILEY JORGENSEN
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1306697750
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNA HAILEY JORGENSEN
Provider Business Mailing Address
First Line : 2655 ENTERPRISE RD
Second Line :
City : RENO
State : NV
Zip : 89512-1666
Country : US
Telephone Number : 775-688-2472
Fax Number :
Provider Business Practice Location Address
First Line : 2655 ENTERPRISE RD
Second Line :
City : RENO
State : NV
Zip : 89512-1666
Country : US
Telephone Number : 775-688-2472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2024
Last Update Date : 12/31/2025

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Directions to “ BRIANNA HAILEY JORGENSEN ” Practice Location

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