Provider Demographics
NPI:1952059909
Name:HART, BRIANNA (AGACNP, MSN)
Entity Type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:AGACNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11325 YULE MARBLE HTS APT 303
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-4270
Mailing Address - Country:US
Mailing Address - Phone:719-649-4330
Mailing Address - Fax:
Practice Address - Street 1:5700 S QUEBEC ST STE 310
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2008
Practice Address - Country:US
Practice Address - Phone:720-941-5580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0997389363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care