Provider Demographics
NPI:1447575741
Name:MCGUANE, BRENDA LYNN (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:LYNN
Last Name:MCGUANE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7549 POTTER RD
Mailing Address - Street 2:
Mailing Address - City:INTERLAKEN
Mailing Address - State:NY
Mailing Address - Zip Code:14847-9665
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 NORTH PARK ST.
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148
Practice Address - Country:US
Practice Address - Phone:315-568-9412
Practice Address - Fax:315-568-6718
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY551811163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health