Provider Demographics
NPI:1881756690
Name:STROM, BRENDA LYNN (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:LYNN
Last Name:STROM
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 1:2531 E LIBRA ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-1108
Mailing Address - Country:US
Mailing Address - Phone:480-545-7001
Mailing Address - Fax:
Practice Address - Street 1:1211 E GUADALUPE RD
Practice Address - Street 2:PATTERSON ELEMENTARY
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-4889
Practice Address - Country:US
Practice Address - Phone:480-892-2803
Practice Address - Fax:480-926-3674
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN049399163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN049399OtherRN LICENSE