Provider Demographics
NPI:1356067144
Name:LE BRON, DENISE GERALDINE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:GERALDINE
Last Name:LE BRON
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 1:2535 S MERIDIAN APT W203
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-1636
Mailing Address - Country:US
Mailing Address - Phone:253-219-6848
Mailing Address - Fax:
Practice Address - Street 1:9502 176TH ST E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-9300
Practice Address - Country:US
Practice Address - Phone:253-846-5386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00122456163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse