Brianne Kaikaina Costa, RN

Individual provider Active NPI Registered Nurse · Sweet Home, OR

NPI 1023397239 · NPPES record last updated Aug 5, 2011

Key facts

NPI
1023397239
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
201141868 (OR)
Practice address
759 27TH Ave
Sweet Home, OR 97386-2994
Phone
(541) 367-8507
NPI assigned
Aug 5, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
201141868ORMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201141868 OR Yes

Addresses

Primary practice location

759 27TH Ave
Sweet Home, OR 97386-2994

Mailing address

38629 SW Elderberry St
Scio, OR 97374-3907
Phone (503) 302-3288

Other providers in Sweet Home, OR

All providers in Sweet Home, OR · Registered Nurse in Oregon

Sources for this page

Verify at the official NPI Registry.