Provider Demographics
NPI:1609359850
Name:DEGAETANO, BRIANNA JOY (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:JOY
Last Name:DEGAETANO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:JOY
Other - Last Name:HELDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:621 JOPPA RD
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-8402
Mailing Address - Country:US
Mailing Address - Phone:848-888-2144
Mailing Address - Fax:
Practice Address - Street 1:1500 RED RIVER ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1918
Practice Address - Country:US
Practice Address - Phone:512-324-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical