Provider Demographics
NPI:1811321037
Name:WHITE, BRIANNA
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 ROSEBUD DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6294
Mailing Address - Country:US
Mailing Address - Phone:406-969-4812
Mailing Address - Fax:406-969-4814
Practice Address - Street 1:2040 ROSEBUD DR
Practice Address - Street 2:SUITE 7
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6294
Practice Address - Country:US
Practice Address - Phone:406-969-4812
Practice Address - Fax:406-969-4814
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator