Provider Demographics
NPI:1053843557
Name:ANTHONY, BRIANNA (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1638 HAYWOOD PL
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2289
Mailing Address - Country:US
Mailing Address - Phone:720-840-8984
Mailing Address - Fax:
Practice Address - Street 1:2020 LOWE ST UNIT 202
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3606
Practice Address - Country:US
Practice Address - Phone:970-893-2758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.006028207Q00000X
CO0060628207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine