Provider Demographics
NPI:1396084489
Name:GUNTURU, BRIE HYLAND (RN)
Entity type:Individual
Prefix:MRS
First Name:BRIE
Middle Name:HYLAND
Last Name:GUNTURU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8250 E HARVARD AVE
Mailing Address - Street 2:APT 9308
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-3990
Mailing Address - Country:US
Mailing Address - Phone:225-573-5631
Mailing Address - Fax:
Practice Address - Street 1:4851 INDEPENDENCE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6715
Practice Address - Country:US
Practice Address - Phone:303-425-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1618649163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse