Provider Demographics
NPI:1275168916
Name:STONE, BRIAN ALEXANDER (APRN)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ALEXANDER
Last Name:STONE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:MR
Other - First Name:BRIAN
Other - Middle Name:ALEXANDER
Other - Last Name:CUCHENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4504 GOLDFINCH WAY
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-8724
Mailing Address - Country:US
Mailing Address - Phone:850-333-3845
Mailing Address - Fax:
Practice Address - Street 1:151 E REDSTONE AVE
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-5352
Practice Address - Country:US
Practice Address - Phone:850-333-3845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11006416363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care