Provider Demographics
NPI:1043959968
Name:BRIARD, BRETT
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:BRIARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 MILL RD APT 227
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5328
Mailing Address - Country:US
Mailing Address - Phone:916-390-7433
Mailing Address - Fax:
Practice Address - Street 1:2109 MILL RD APT 227
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-5328
Practice Address - Country:US
Practice Address - Phone:916-390-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant