Provider Demographics
NPI:1427762483
Name:ORDEN, BRYAN RICHARD (APRN-CNP PMHMP)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:RICHARD
Last Name:ORDEN
Suffix:
Gender:M
Credentials:APRN-CNP PMHMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9308 CANALINO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-0538
Mailing Address - Country:US
Mailing Address - Phone:702-839-8868
Mailing Address - Fax:
Practice Address - Street 1:9308 CANALINO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-0538
Practice Address - Country:US
Practice Address - Phone:702-839-8868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV821997363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health