Active NPI
Brianna Ennis
- Registered Nurse
- Port Saint Lucie, FL
National Provider Identifier
1366239683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 9672791
- Practice address
- 6399 NW Sweetwood Dr
Port Saint Lucie, FL 34987-5856 - Phone
- (520) 465-6617
- NPI assigned
- Apr 21, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 9672791 | FL | Primary |
| Registered Nurse | 163W00000X | 95339533 | CA |
Addresses
Primary practice location
6399 NW Sweetwood Dr
Port Saint Lucie, FL 34987-5856
Mailing address
6399 NW Sweetwood Dr
Port Saint Lucie, FL 34987-5856
Phone (520) 465-6617
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95339533 | CA | MD | Registered Nurse |
| 9672791 | FL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745193600000",
"number": "1366239683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6399 NW SWEETWOOD DR",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349875856",
"telephone_number": "520-465-6617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6399 NW SWEETWOOD DR",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349875856",
"telephone_number": "520-465-6617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENNIS",
"first_name": "BRIANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-21",
"last_updated": "2025-04-21",
"certification_date": "2025-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "9672791",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95339533",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.