Provider Demographics
NPI:1396391827
Name:KUSTER, BRIANNA NICOLE (DNP)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:NICOLE
Last Name:KUSTER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12808 KING ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4415
Mailing Address - Country:US
Mailing Address - Phone:913-748-9837
Mailing Address - Fax:
Practice Address - Street 1:3351 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-4006
Practice Address - Country:US
Practice Address - Phone:816-966-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2019028279363LF0000X
MO2019028279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily