Provider Demographics
NPI:1124323910
Name:LLAMAS, BRIANNA MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MICHELLE
Last Name:LLAMAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32963 SANDAL WOOD LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-6287
Mailing Address - Country:US
Mailing Address - Phone:949-291-4218
Mailing Address - Fax:
Practice Address - Street 1:32963 SANDAL WOOD LN
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-6287
Practice Address - Country:US
Practice Address - Phone:949-291-4218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA784653163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice