Provider Demographics
NPI:1942480876
Name:DIGGS, BRENDA J (RN)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:J
Last Name:DIGGS
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 1:4086 PRINCETON BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2344
Mailing Address - Country:US
Mailing Address - Phone:216-820-7638
Mailing Address - Fax:216-291-0682
Practice Address - Street 1:4086 PRINCETON BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-2344
Practice Address - Country:US
Practice Address - Phone:216-820-7638
Practice Address - Fax:216-291-0682
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH190505163WC1500X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health