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NPI Code Detail

MEDICARE: DENNIS BRANDON RUNYON

MEDICARE:   DENNIS BRANDON RUNYON
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
1163W00000XRegistered Nurse28282019AIN

General Provider Information

NPI Number : 1669311932
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS BRANDON RUNYON
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11109 PARKVIEW PLAZA DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number : 260-672-6620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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Directions to “ DENNIS BRANDON RUNYON ” Practice Location

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