Provider Demographics
NPI:1407028814
Name:JOHNDROW, BRENDA JANE (RN)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JANE
Last Name:JOHNDROW
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 1:2950 SW ARCHER RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1843
Mailing Address - Country:US
Mailing Address - Phone:352-264-7770
Mailing Address - Fax:
Practice Address - Street 1:2950 SW ARCHER RD
Practice Address - Street 2:SUITE C
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1843
Practice Address - Country:US
Practice Address - Phone:352-264-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9184233163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator