Provider Demographics
NPI:1194467852
Name:SURGENTO, BRIANNA NICOLE (MSN, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:NICOLE
Last Name:SURGENTO
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5565 GRASSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-3700
Mailing Address - Country:US
Mailing Address - Phone:401-633-5556
Mailing Address - Fax:
Practice Address - Street 1:6630 S MCCARRAN BLVD STE A12
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6114
Practice Address - Country:US
Practice Address - Phone:775-221-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV826336363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health