MEDICARE: BRENDA SUE REE LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	10925	WV

General Provider Information

NPI Number	:	1407789456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA SUE REE LPN

Provider Business Mailing Address
First Line	:	420 SCOTT RD
Second Line	:
City	:	NORTON
State	:	WV
Zip	:	26285-4542
Country	:	US
Telephone Number	:	304-974-5000
Fax Number	:	304-472-0225

Provider Business Practice Location Address
First Line	:	4 NORTHRIDGE DR STE 120
Second Line	:
City	:	BUCKHANNON
State	:	WV
Zip	:	26201-8484
Country	:	US
Telephone Number	:	304-974-5000
Fax Number	:	304-472-0225

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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