Provider Demographics
NPI:1215298153
Name:NEGRON, BRENDALIS (RN,BSN)
Entity type:Individual
Prefix:MS
First Name:BRENDALIS
Middle Name:
Last Name:NEGRON
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1350
Mailing Address - Street 2:
Mailing Address - City:SAINT JUST STATION
Mailing Address - State:PR
Mailing Address - Zip Code:00978
Mailing Address - Country:US
Mailing Address - Phone:787-710-2532
Mailing Address - Fax:
Practice Address - Street 1:CALLE ANICETO DIAZ INT 876
Practice Address - Street 2:
Practice Address - City:SAINT JUST STATION
Practice Address - State:PR
Practice Address - Zip Code:00978
Practice Address - Country:US
Practice Address - Phone:787-710-2532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR32100163WD1100X, 163WN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0300XNursing Service ProvidersRegistered NurseNephrology
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal