Provider Demographics
NPI:1649845413
Name:CLARY, BRIGITTE ANN (RN)
Entity type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:ANN
Last Name:CLARY
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 1:2518 HIDDEN SPRINGS LOOP SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-4011
Mailing Address - Country:US
Mailing Address - Phone:910-391-2860
Mailing Address - Fax:
Practice Address - Street 1:2518 HIDDEN SPRINGS LOOP SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-4011
Practice Address - Country:US
Practice Address - Phone:910-391-2860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61022260163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse