Provider Demographics
NPI:1033913645
Name:KELLEY, BRIANA (CNA)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:KELLEY
Suffix:
Gender:
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 W CONCORDIA AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-3856
Mailing Address - Country:US
Mailing Address - Phone:313-787-7252
Mailing Address - Fax:
Practice Address - Street 1:8300 W CONCORDIA AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-3856
Practice Address - Country:US
Practice Address - Phone:313-787-7252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIWI038550601679251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care