Provider Demographics
NPI:1548996556
Name:CROSS, BRIANNA (AUD)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:CROSS
Suffix:
Gender:
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 TESLA DR
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-0812
Mailing Address - Country:US
Mailing Address - Phone:336-413-0815
Mailing Address - Fax:
Practice Address - Street 1:3700 TESLA DR
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-0812
Practice Address - Country:US
Practice Address - Phone:336-413-0815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30001075231H00000X
IN23002814A231H00000X
FLAY2906231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist