Provider Demographics
NPI:1558085076
Name:TEMPLETON, BRIAN R (RN)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:R
Last Name:TEMPLETON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 WESTRIDGE AVE W APT L201
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98466-1860
Mailing Address - Country:US
Mailing Address - Phone:253-343-8774
Mailing Address - Fax:
Practice Address - Street 1:2220 WESTRIDGE AVE W APT L201
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98466-1860
Practice Address - Country:US
Practice Address - Phone:253-343-8774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61053428163WP2201X
WARN61053428163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Multi-Specialty
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care