Provider Demographics
NPI:1568277192
Name:JOHN, BRIANNA (FNP)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:JOHN
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6413 HIGHWAY 182 E
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-2041
Mailing Address - Country:US
Mailing Address - Phone:985-509-8101
Mailing Address - Fax:
Practice Address - Street 1:6413 HIGHWAY 182 E
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-2041
Practice Address - Country:US
Practice Address - Phone:985-509-8101
Practice Address - Fax:985-509-8102
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA239776363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily