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NPI Code Detail

MEDICARE: RENEE E BRASSELL RN

MEDICARE:   RENEE E BRASSELL  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 NurseRN99971SC
2163WE0003XEmergency Registered NurseRN99971SC

General Provider Information

NPI Number : 1891017018
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE E BRASSELL RN
Provider Business Mailing Address
First Line : 6730 KACI LN
Second Line :
City : INDIAN LAND
State : SC
Zip : 29707-3201
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6730 KACI LN
Second Line :
City : INDIAN LAND
State : SC
Zip : 29707-3201
Country : US
Telephone Number : 724-510-9620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2010
Last Update Date : 02/16/2010

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Directions to “ RENEE E BRASSELL RN” Practice Location

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