Provider Demographics
NPI:1003545542
Name:LAFFERTY, BRIANNA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:LAFFERTY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9099 E LANSING RD STE A
Mailing Address - Street 2:
Mailing Address - City:DURAND
Mailing Address - State:MI
Mailing Address - Zip Code:48429-1083
Mailing Address - Country:US
Mailing Address - Phone:989-288-2651
Mailing Address - Fax:989-288-2087
Practice Address - Street 1:9099 E LANSING RD STE A
Practice Address - Street 2:
Practice Address - City:DURAND
Practice Address - State:MI
Practice Address - Zip Code:48429-1083
Practice Address - Country:US
Practice Address - Phone:989-288-2651
Practice Address - Fax:989-288-2087
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704343404163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse