Provider Demographics
NPI:1659101863
Name:STANGELAND, BRIANNA (APRN)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:STANGELAND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1060
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:AR
Mailing Address - Zip Code:72650-1060
Mailing Address - Country:US
Mailing Address - Phone:870-448-5101
Mailing Address - Fax:870-448-3767
Practice Address - Street 1:934 N GASKILL ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72740-1319
Practice Address - Country:US
Practice Address - Phone:479-738-5500
Practice Address - Fax:479-738-1350
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR213289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily