Provider Demographics
NPI:1427556786
Name:MCNAIR, BRENDA JOYCE (RN)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:JOYCE
Last Name:MCNAIR
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 1:3859 THORNCROFT LN UNIT A
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-2293
Mailing Address - Country:US
Mailing Address - Phone:310-889-6261
Mailing Address - Fax:
Practice Address - Street 1:1776 E CENTURY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-3050
Practice Address - Country:US
Practice Address - Phone:323-374-6691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA483103163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse