Doctor Name: | BRENDA CLEVELAND |
NPI Number: | 1043695331 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | RN176250 |
Business Practice Address: | 300 W Hospital Rd Fort Gordon, GA - 309055741 |
Business Phone Number: | 7067872552 |
Business Fax Number: | |
Mailing Address: | 300 W Hospital Rd, FORT GORDON |
State: | GA |
Postal Code: | 309055741 |
Phone Number: | 7067872552 |
Fax Number: | |
NPI Enumeration Date: | 07/28/2015 |
NPI Last Update Date: | 07/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0000X |
License Number: | RN176250 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Pain Management |
Taxonomy Definition: |