MEDICARE: BRIANNA REZICH MS, CGC

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	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1821570755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA REZICH MS, CGC

Provider Business Mailing Address
First Line	:	985450 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-5450
Country	:	US
Telephone Number	:	402-559-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	985440 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-5440
Country	:	US
Telephone Number	:	402-559-8400
Fax Number	:

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

Provider Enumeration Date	:	09/06/2018
Last Update Date	:	01/24/2022

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