Provider Demographics
NPI:1740310358
Name:RIZZO, BRENDA KAE (CNS)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:KAE
Last Name:RIZZO
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 GLENSIDE LN
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-9485
Mailing Address - Country:US
Mailing Address - Phone:740-549-2217
Mailing Address - Fax:
Practice Address - Street 1:469 GLENSIDE LN
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9485
Practice Address - Country:US
Practice Address - Phone:740-549-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN156563163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory