Provider Demographics
NPI:1134490600
Name:RIEDL, BRIEANN NICHOLE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:BRIEANN
Middle Name:NICHOLE
Last Name:RIEDL
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 ANACAPA ST
Mailing Address - Street 2:SUITE 20176
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93102-9989
Mailing Address - Country:US
Mailing Address - Phone:805-455-9727
Mailing Address - Fax:
Practice Address - Street 1:836 ANACAPA ST
Practice Address - Street 2:SUITE 20176
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93102-9989
Practice Address - Country:US
Practice Address - Phone:805-455-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-15
Last Update Date:2012-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA740044163W00000X, 163WH0200X, 163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WE0003XNursing Service ProvidersRegistered NurseEmergency