Provider Demographics
NPI:1689051971
Name:HUPP, BRIANA (BSN RN)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:HUPP
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 SILVER SPRINGS LN NE
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-9407
Mailing Address - Country:US
Mailing Address - Phone:503-507-0873
Mailing Address - Fax:
Practice Address - Street 1:1628 SILVER SPRINGS LN NE
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-9407
Practice Address - Country:US
Practice Address - Phone:503-507-0873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
OR201508047RN163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst