Provider Demographics
NPI:1154388908
Name:GARNER, BRIGETT LEIGH (NP)
Entity type:Individual
Prefix:
First Name:BRIGETT
Middle Name:LEIGH
Last Name:GARNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:655 S DOBSON RD
Mailing Address - Street 2:STE 101
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5668
Mailing Address - Country:US
Mailing Address - Phone:480-844-4702
Mailing Address - Fax:480-844-4323
Practice Address - Street 1:455 E 6TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-7118
Practice Address - Country:US
Practice Address - Phone:480-844-4702
Practice Address - Fax:480-844-4323
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY534660163W00000X
AZ172842163W00000X
NY420740363LW0102X
NY304149363LA2200X
AZ4403363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00243352OtherMMIS PROVIDER ID
NY1653G1Medicare PIN