Provider Demographics
NPI:1841371051
Name:KIDD, BRIAN PATRICK (MSN)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:PATRICK
Last Name:KIDD
Suffix:
Gender:M
Credentials:MSN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:26838 TANIC DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4617
Mailing Address - Country:US
Mailing Address - Phone:813-431-6149
Mailing Address - Fax:813-991-4403
Practice Address - Street 1:26838 TANIC DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4617
Practice Address - Country:US
Practice Address - Phone:813-431-6149
Practice Address - Fax:813-991-4403
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL9403050363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology