Individual provider Active NPI

Brianna Lastre, DNP, WHNP, CNM

  • Women's Health Nurse Practitioner
  • Pleasant Grove, UT
National Provider Identifier
1194157123
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
7247318-4405 Issued in UT
Practice address
1446 W Pleasant Grove Blvd.
Pleasant Grove, UT 84062
Phone
(801) 785-5100
NPI assigned
Aug 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 7247318-4405 UT Primary

Addresses

Primary practice location

1446 W Pleasant Grove Blvd.
Pleasant Grove, UT 84062

Mailing address

1446 W Pleasant Grove Blvd.
Pleasant Grove, UT 84062
Phone (801) 785-5100

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
7247318-4405UTMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Fertility Center Past Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1194157123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 W PLEASANT GROVE BLVD.",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "84062",
            "telephone_number": "801-785-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 W PLEASANT GROVE BLVD.",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "84062",
            "telephone_number": "801-785-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASTRE",
        "first_name": "BRIANNA",
        "name_prefix": "Dr.",
        "credential": "DNP, WHNP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "UT",
            "license": "7247318-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Grove, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.