Individual
BRIANA NICOLE CANTORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3807 SPRING ST, MOUNT PLEASANT, WI 53405-1667
(312) 813-8440
Mailing address
17747 W DARTMOOR DR, GRAYSLAKE, IL 60030-1996
(312) 813-8440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7658
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
09/12/2022
Last updated
01/02/2024
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