Individual provider · NPI-1
Jean Brudent
Perfusionist · El Paso, TX
NPI number1457099772
StatusActive
Last updated in NPPESMay 25, 2022
Details
- NPI
- 1457099772
- Entity type
- Individual (NPI-1)
- Name
- Jean Brudent
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 25, 2022
- Certification date
- May 25, 2022
- Last updated
- May 25, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 242T00000X | Perfusionist | 171240555 | FL | Yes |
| 253J00000X | Foster Care Agency | 171240555 | FL |
Practice location
3111 Edgerock DrEl Paso, TX 79935-1524
Phone 915-540-0805
Mailing address
700 Woodland AveEl Paso, TX 79922-2040
Phone 915-540-0805
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.