Provider Demographics
NPI:1225340938
Name:PLANTE, BRIANNE NICOLE (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIANNE
Middle Name:NICOLE
Last Name:PLANTE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BRIANNE
Other - Middle Name:NICOLE
Other - Last Name:PAULSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1315 W. LANE AVE
Mailing Address - Street 2:STE D
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-3544
Mailing Address - Country:US
Mailing Address - Phone:614-457-4827
Mailing Address - Fax:614-326-0250
Practice Address - Street 1:1315 W. LANE AVE
Practice Address - Street 2:STE D
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3544
Practice Address - Country:US
Practice Address - Phone:614-457-4827
Practice Address - Fax:614-326-0250
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34011258207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0104360Medicaid