Provider Demographics
NPI:1538906508
Name:VESCO, BRIANNA ROSE (PMHNP)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:ROSE
Last Name:VESCO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W SILVER ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1518
Mailing Address - Country:US
Mailing Address - Phone:406-444-1069
Mailing Address - Fax:
Practice Address - Street 1:711 W SILVER ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1518
Practice Address - Country:US
Practice Address - Phone:406-444-1069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-157804163W00000X
MTNUR-APRN-LIC-240135363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse