Provider Demographics
NPI:1427821149
Name:LIND, DENELLE (RN)
Entity type:Individual
Prefix:
First Name:DENELLE
Middle Name:
Last Name:LIND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11409 N PIONEER RD
Mailing Address - Street 2:
Mailing Address - City:PROSSER
Mailing Address - State:WA
Mailing Address - Zip Code:99350-9612
Mailing Address - Country:US
Mailing Address - Phone:509-786-8600
Mailing Address - Fax:
Practice Address - Street 1:1000 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-5533
Practice Address - Country:US
Practice Address - Phone:509-222-6570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00130138163WS0200X
WARN00131038163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool