Provider Demographics
NPI:1255116240
Name:SORTLAND, BRIANNA (FNP-BC)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:SORTLAND
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 KEOLU DR
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3873
Mailing Address - Country:US
Mailing Address - Phone:808-272-0444
Mailing Address - Fax:
Practice Address - Street 1:1005 KEOLU DR
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3873
Practice Address - Country:US
Practice Address - Phone:808-272-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4213-0363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner