MEDICARE: CORINNA BRISENO

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	163WS0200X	School Registered Nurse	313361	AZ

General Provider Information

NPI Number	:	1922966449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORINNA BRISENO

Provider Business Mailing Address
First Line	:	2110 S GRANADA DR APT A
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-2257
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 E AEPLI DR
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-2205
Country	:	US
Telephone Number	:	480-967-6599
Fax Number	:

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

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “ CORINNA BRISENO ” Practice Location

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