Provider Demographics
NPI:1336975556
Name:CAGGIANO, BRIEANA N
Entity type:Individual
Prefix:
First Name:BRIEANA
Middle Name:N
Last Name:CAGGIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-1432
Mailing Address - Country:US
Mailing Address - Phone:609-668-8609
Mailing Address - Fax:
Practice Address - Street 1:890 AURARIA PKWY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1806
Practice Address - Country:US
Practice Address - Phone:303-615-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program