Provider Demographics
NPI:1598529562
Name:FREI-WATSON, BRIEANNA LYNN (BIRTH DOULA, NAC)
Entity Type:Individual
Prefix:
First Name:BRIEANNA
Middle Name:LYNN
Last Name:FREI-WATSON
Suffix:
Gender:F
Credentials:BIRTH DOULA, NAC
Other - Prefix:
Other - First Name:BRIEANNA
Other - Middle Name:LYNN
Other - Last Name:FREI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NAC
Mailing Address - Street 1:1354 INDIAN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-5121
Mailing Address - Country:US
Mailing Address - Phone:208-305-6186
Mailing Address - Fax:
Practice Address - Street 1:1354 INDIAN HILLS DR
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-5121
Practice Address - Country:US
Practice Address - Phone:208-305-6186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANC60796015376K00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No376K00000XNursing Service Related ProvidersNurse's Aide