Provider Demographics
NPI:1104656917
Name:WROBLEWSKI, BRYCE ANDREW
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:ANDREW
Last Name:WROBLEWSKI
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:WROBLEWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:135 N SIERRA ST # 798
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-1344
Mailing Address - Country:US
Mailing Address - Phone:407-491-0448
Mailing Address - Fax:
Practice Address - Street 1:1135 TERMINAL WAY STE 208
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2168
Practice Address - Country:US
Practice Address - Phone:775-686-6021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide