Provider Demographics
NPI:1427928357
Name:POLETIS, BRIANNA VICTORIA (APRN, AGACNP-BC)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:VICTORIA
Last Name:POLETIS
Suffix:
Gender:F
Credentials:APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 SW SAVANNAH DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2372
Mailing Address - Country:US
Mailing Address - Phone:913-227-9149
Mailing Address - Fax:
Practice Address - Street 1:905 SW SAVANNAH DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2372
Practice Address - Country:US
Practice Address - Phone:913-227-9149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025047940363LA2100X
KS13-156952-081163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse