Provider Demographics
NPI:1851661102
Name:STANLEY, BRIAN ALLEN (ARNP)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ALLEN
Last Name:STANLEY
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:CARRINGTON
Mailing Address - State:ND
Mailing Address - Zip Code:58421-1217
Mailing Address - Country:US
Mailing Address - Phone:701-652-3141
Mailing Address - Fax:
Practice Address - Street 1:800 4TH ST N
Practice Address - Street 2:
Practice Address - City:CARRINGTON
Practice Address - State:ND
Practice Address - Zip Code:58421-1217
Practice Address - Country:US
Practice Address - Phone:701-652-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003836A363L00000X, 363LF0000X
NDR41658363LF0000X
KY3007595363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1464658Medicaid