Individual
BRIANNA VANCE FAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
600 N CATTLEMEN RD STE 200, SARASOTA, FL 34232-6422
(941) 377-9993
(941) 343-0026
Mailing address
9539 59TH AVE E, BRADENTON, FL 34202-9680
(440) 821-8754
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
11013046
FL
363LG0600X
Gerontology Nurse Practitioner
11013046
FL
363LP2300X
Primary Care Nurse Practitioner
11013046
FL
Other
Enumeration date
05/10/2021
Last updated
05/20/2021
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