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NPI Code Detail

MEDICARE: BRENDA MCNEIL RN

MEDICARE: BRENDA MCNEIL RN
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 Nurse4704201413MI

General Provider Information

NPI Number : 1699785436
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA MCNEIL RN
Provider Business Mailing Address
First Line : 1490 E BELTLINE AVE SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49506-4336
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1490 E BELTLINE AVE SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49506-4336
Country : US
Telephone Number : 616-363-7272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 02/13/2024

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