Provider Demographics
NPI:1740409200
Name:WELLINGTON, BRIANA TRUEHILL (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIANA
Middle Name:TRUEHILL
Last Name:WELLINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:MICHELLE
Other - Last Name:TRUEHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3630
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86003-3630
Mailing Address - Country:US
Mailing Address - Phone:928-522-9400
Mailing Address - Fax:928-774-4808
Practice Address - Street 1:2920 N 4TH ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004
Practice Address - Country:US
Practice Address - Phone:928-522-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025527207V00000X
AZ48005207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06832329Medicaid
AZ835315Medicaid
LA1576824Medicaid
LA1576824Medicaid
LA4F294Medicare UPIN
LA4F294Medicare PIN
LA4F294DD21Medicare PIN