Provider Demographics
NPI:1851650386
Name:BRILEY, KATHERINE LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LYNN
Last Name:BRILEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4237 S 147TH PLZ APT 302
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-5537
Mailing Address - Country:US
Mailing Address - Phone:402-708-6112
Mailing Address - Fax:
Practice Address - Street 1:4237 S 147TH PLZ APT 302
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-5537
Practice Address - Country:US
Practice Address - Phone:402-708-6112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor