Provider Demographics
NPI:1396305389
Name:BINGHAM, BRIANNA RACHELLE (DO)
Entity type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:RACHELLE
Last Name:BINGHAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:BRIANNA
Other - Middle Name:RACHELLE
Other - Last Name:CLINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:12140 NALL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2504
Mailing Address - Country:US
Mailing Address - Phone:913-345-8500
Mailing Address - Fax:
Practice Address - Street 1:12140 NALL AVE STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2504
Practice Address - Country:US
Practice Address - Phone:913-345-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-46446207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine