Provider Demographics
NPI:1144806878
Name:WARTH, BRIANA LYN
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:LYN
Last Name:WARTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:LYN
Other - Last Name:HINCKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:112 NOLAN TRACE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446
Mailing Address - Country:US
Mailing Address - Phone:337-404-7731
Mailing Address - Fax:
Practice Address - Street 1:112 NOLAN TRACE
Practice Address - Street 2:SUITE B
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446
Practice Address - Country:US
Practice Address - Phone:337-404-7731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator