Healthcare Provider Details

I. General information

NPI: 1184407967
Provider Name (Legal Business Name): BRENDA ANNETTE CURRY LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 EAST GAMBIER STREET
MOUNT VERNON OH
43050-3510
US

IV. Provider business mailing address

106 E GAMBIER ST
MOUNT VERNON OH
43050-3510
US

V. Phone/Fax

Practice location:
  • Phone: 740-397-2660
  • Fax: 740-392-3613
Mailing address:
  • Phone: 740-397-2660
  • Fax: 740-392-3613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.116839.MEDS-IV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: