Individual provider · NPI-1
Brenda Dale Fasone, RN-inactive license
Technician, Attendant Care Provider · Bowie, MD
NPI number1619793353
StatusActive
Last updated in NPPESNov 26, 2024
Details
- NPI
- 1619793353
- Entity type
- Individual (NPI-1)
- Name
- Brenda Dale Fasone
- Credential
- RN-inactive license
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 26, 2024
- Certification date
- Nov 26, 2024
- Last updated
- Nov 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
14108 Wainwright CtBowie, MD 20715-1738
Phone 301-875-9532 · Fax 301-262-5158
Mailing address
14108 Wainwright CtBowie, MD 20715-1738
Phone 301-875-9532 · Fax 301-262-5158
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