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General NPI Number Information
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NPI Number | 1194798850
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Entity Type | Individual
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Provider Name | BRENDA GAIL REGISTER RN
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Gender | Female
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 305 W CENTRAL AVE
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City | LAKE WALES
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State | FL
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Zip | 33853-4015
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Country | US
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Telephone | 863-678-4144
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 GOLFVIEW AVE BILLING DEPARTMENT
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City | BARTOW
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State | FL
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Zip | 33830-6738
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Country | US
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Telephone | 863-519-7900
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Fax | 863-519-7696
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | RN2210022
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License Number State | FL
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