Provider Demographics
NPI:1265605778
Name:ROBY, BRIANNE BARNETT (MD)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:BARNETT
Last Name:ROBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIANNE
Other - Middle Name:CLAIRE
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:347 SMITH AVE N
Mailing Address - Street 2:PEDIATRIC ENT AND FACIAL PLASTIC SURGERY, SUITE 600
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2387
Mailing Address - Country:US
Mailing Address - Phone:612-874-1292
Mailing Address - Fax:
Practice Address - Street 1:347 SMITH AVE N
Practice Address - Street 2:PEDIATRIC ENT AND FACIAL PLASTIC SURGERY, SUITE 600
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2387
Practice Address - Country:US
Practice Address - Phone:612-874-1292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN57062207Y00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology