Provider Demographics
NPI:1821689886
Name:SUTTON-CASTELLANOS, BRIANNA DANIELLE
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:DANIELLE
Last Name:SUTTON-CASTELLANOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 N 7TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-2897
Mailing Address - Country:US
Mailing Address - Phone:580-649-9429
Mailing Address - Fax:
Practice Address - Street 1:1501 LERA STE 5
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-2671
Practice Address - Country:US
Practice Address - Phone:580-649-9429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator