Provider Demographics
NPI:1316425218
Name:GONZALES, BRIANNA ANITA (LVN)
Entity type:Individual
Prefix:MISS
First Name:BRIANNA
Middle Name:ANITA
Last Name:GONZALES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-4334
Mailing Address - Country:US
Mailing Address - Phone:830-279-4495
Mailing Address - Fax:
Practice Address - Street 1:310 FLORENCE ST
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-4334
Practice Address - Country:US
Practice Address - Phone:830-279-4495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX338229164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse