Provider Demographics
NPI:1124617071
Name:BRIGGS, CALLIE MARIE (FNP)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:MARIE
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74020 ALESSANDRO DR STE B
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3707
Mailing Address - Country:US
Mailing Address - Phone:760-837-8827
Mailing Address - Fax:760-773-1225
Practice Address - Street 1:74020 ALESSANDRO DR STE B
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-3707
Practice Address - Country:US
Practice Address - Phone:760-837-8827
Practice Address - Fax:760-773-1225
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010244363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care