Most Relevant Information
Provider Data
| NPI Number: | 1003485632 |
| Provider Name: | BRENDA MARIE DIAZ |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | LPN0000094744 |
Most Important Dates
| Enumeration Date: | 06/18/2021 |
| Last Updated: | 06/18/2021 |
Provider Practice Location
334 EAGLE LN
EVENSVILLE
TN
37332
Practice Location Phone/Fax
| Phone: | 4237757819 |
| Fax: | 4237758078 |
Provider Mailing Location
334 EAGLE LN
EVENSVILLE
TN
37332
Provider Mailing Phone/Fax
| Phone: | 4237757819 |
| Fax: | 4237758078 |