Provider Demographics
NPI:1851805089
Name:SYRON, BREANN LYNN (RN)
Entity Type:Individual
Prefix:
First Name:BREANN
Middle Name:LYNN
Last Name:SYRON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BREANN
Other - Middle Name:LYNN
Other - Last Name:RANDOLPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2821 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-5501
Mailing Address - Country:US
Mailing Address - Phone:360-577-2772
Mailing Address - Fax:
Practice Address - Street 1:2821 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-5501
Practice Address - Country:US
Practice Address - Phone:360-577-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60575089163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool