Provider Demographics
NPI:1992109102
Name:GIOVANNINI, BRIANNE (LPN)
Entity type:Individual
Prefix:MRS
First Name:BRIANNE
Middle Name:
Last Name:GIOVANNINI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12101 181ST AVE E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-6901
Mailing Address - Country:US
Mailing Address - Phone:253-226-4350
Mailing Address - Fax:
Practice Address - Street 1:908 3RD ST
Practice Address - Street 2:
Practice Address - City:STEILACOOM
Practice Address - State:WA
Practice Address - Zip Code:98388-1736
Practice Address - Country:US
Practice Address - Phone:253-983-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP 60446073390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program