Provider Demographics
NPI:1750096244
Name:LINDERMAN, BREANNA (RN, BSN)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:LINDERMAN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4927 W LAURIE LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-6326
Mailing Address - Country:US
Mailing Address - Phone:623-201-9768
Mailing Address - Fax:
Practice Address - Street 1:19602 N 45TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7339
Practice Address - Country:US
Practice Address - Phone:623-445-4310
Practice Address - Fax:623-445-4380
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN197974163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse