Provider Demographics
NPI:1205406576
Name:DELEON, BRENDA P (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:P
Last Name:DELEON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:BRENDA
Other - Middle Name:P
Other - Last Name:DELEON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:102 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-7820
Mailing Address - Country:US
Mailing Address - Phone:308-237-2273
Mailing Address - Fax:308-237-4515
Practice Address - Street 1:102 3RD AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-7820
Practice Address - Country:US
Practice Address - Phone:308-237-2273
Practice Address - Fax:308-237-4515
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE72495163W00000X
NE113711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse