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NPI Code Detail

MEDICARE: JASON ROBERT BRENDLE

MEDICARE: JASON ROBERT BRENDLE
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
1163WP2201XAmbulatory Care Registered NurseRN.350911OH

General Provider Information

NPI Number : 1497472062
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON ROBERT BRENDLE
Provider Business Mailing Address
First Line : 2215 FULLER RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2303
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1200 S DETROIT AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43614-5903
Country : US
Telephone Number : 419-259-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2022
Last Update Date : 03/23/2026

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