Brienna Nichols, CRNA
Nurse Anesthetist, Certified Registered in Phoenix, AZ. Individual provider (NPI-1).
NPI number1760104293
StatusActive
Last updated in NPPESJan 28, 2025
Details
- NPI
- 1760104293
- Entity type
- Individual (NPI-1)
- Name
- Brienna Nichols
- Credential
- CRNA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 12, 2022
- Certification date
- Jan 28, 2025
- Last updated
- Jan 28, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2023020410 | MO | Yes |
| 367500000X | Nurse Anesthetist, Certified Registered | 280929 | AZ | |
| 367500000X | Nurse Anesthetist, Certified Registered | CRNA280929 | AZ |
Practice location
2000 W Bethany Home RdPhoenix, AZ 85015-2443
Phone 602-249-0212
Mailing address
26440 N 99th AvePeoria, AZ 85383-9702
Phone 480-254-1517
Other practice locations
1100 N Kentucky Ave
West Plains, MO 65775-2029
West Plains, MO 65775-2029
Phone 417-256-9111
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