Provider Demographics
NPI:1053477000
Name:BRILLER, NANCY D (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:D
Last Name:BRILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:B
Other - Last Name:GREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:990 SYLVAN WAY
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-2851
Mailing Address - Country:US
Mailing Address - Phone:360-479-3657
Mailing Address - Fax:360-373-7616
Practice Address - Street 1:990 SYLVAN WAY
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-2851
Practice Address - Country:US
Practice Address - Phone:360-479-3657
Practice Address - Fax:360-373-7616
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031412207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA192575000OtherOWCP
WA911577098-07OtherKITSAP PHYSICIANS SERVICE
WA1086818Medicaid
WA911577098OtherPREMERA BLUE CROSS
WA911577098OtherUNIFORM MEDICAL PLAN
WAGR6798OtherREGENCE
WA013194010OtherGROUP HEALTH COOPERATIVE
WA050028290OtherRAILROAD MEDICARE
WA37566OtherLABOR AND INDUSTRIES
115000031Medicare ID - Type Unspecified
WA37566OtherLABOR AND INDUSTRIES