Provider Demographics
NPI:1790675437
Name:ROSALES, BRIANNA S
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:S
Last Name:ROSALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15597 MAXDALE RD
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-3849
Mailing Address - Country:US
Mailing Address - Phone:702-845-2301
Mailing Address - Fax:
Practice Address - Street 1:1809 E RANCIER AVE
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-3737
Practice Address - Country:US
Practice Address - Phone:254-450-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-05
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator