Provider Demographics
NPI:1558381368
Name:BRILES, STEPHEN A (RN, MSN)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:A
Last Name:BRILES
Suffix:
Gender:M
Credentials:RN, MSN
Other - Prefix:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 COCHRANE CIR., ATTN: CREDENTIALS OFFICE
Mailing Address - Street 2:EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4604
Mailing Address - Country:US
Mailing Address - Phone:719-526-7844
Mailing Address - Fax:719-526-7984
Practice Address - Street 1:5236 VALDEZ CIRCLE, BUILDING 5236
Practice Address - Street 2:US ARMY HEALTH CLINIC - DUGWAY PROVING GROUND
Practice Address - City:DUGWAY
Practice Address - State:UT
Practice Address - Zip Code:84022
Practice Address - Country:US
Practice Address - Phone:435-831-2941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT201540-3102163W00000X, 163WX0106X, 364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WX0106XNursing Service ProvidersRegistered NurseOccupational Health
Not Answered364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health